Zero-contrast IVUS-guided complex PCI in a patient with NSTE-ACS and severe renal impairment.
Francesco MorettiMauro RondiFilippo OttaniPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2023)
A 76-year-old male with severe comorbidities and multiple cardiovascular risk factors including stage IV chronic kidney disease presents with non-ST-elevation myocardial infarction. An ultra-low contrast invasive coronary angiography using the DyeVert system and iso-osmolar contrast agent revealed a multivessel disease with heavy calcifications involving the left main stem and its bifurcation requiring a complex percutaneous coronary intervention. Because of the high risk of contrast-induced acute kidney injury, a zero-contrast intervention was performed using intravascular ultrasound guidance and dedicated stenting techniques with optimal imaging, clinical, and renal outcomes. Zero-contrast policies can be safely implemented even in complex clinical scenarios but at least two orthogonal angiographic projections should always be acquired to rule out distal complications.
Keyphrases
- percutaneous coronary intervention
- st elevation myocardial infarction
- magnetic resonance
- acute coronary syndrome
- st segment elevation myocardial infarction
- antiplatelet therapy
- cardiovascular risk factors
- acute kidney injury
- coronary artery disease
- acute myocardial infarction
- chronic kidney disease
- contrast enhanced
- coronary artery bypass grafting
- high resolution
- atrial fibrillation
- magnetic resonance imaging
- heart failure
- coronary artery
- oxidative stress
- climate change
- cardiovascular disease
- cardiac surgery
- high glucose
- single cell
- diabetic rats
- end stage renal disease
- left ventricular
- endovascular treatment
- skeletal muscle
- insulin resistance
- adipose tissue