Successful non contrast percutaneous coronary intervention for patient with unstable angina and prior anaphylactic...

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Patient history of angina, percutaneous coronary intervention, and coronary bypass surgery.
• Hospitalization for epigastralgia and tarry stool, indicating potential gastrointestinal bleeding.
• Previous uneventful percutaneous coronary intervention without allergic reaction to contrast media.

Observation:

• Hypotension and chest pain during enhanced computed tomography.
• Recurrent hypotension during coronary angiography (CAG).
• Significant coronary artery stenosis in the right coronary artery identified via CAG.

Findings:

• Successful coronary interventional procedure for severe coronary artery stenosis.
• Utilized intravascular ultrasound and a second wire as a marker for stent implantation.
• Achieved successful stent implantation without the use of iodinated contrast media.

Implications:

• Demonstrates a viable alternative for contrast-enhanced procedures in high-risk patients.
• Highlights the utility of intravascular ultrasound and marker wires in complex interventional cardiology.
• Offers a novel approach for managing patients with contraindications or severe reactions to contrast media.