Zero-Contrast Intravascular Lithotripsy Angioplasty Facilitated by Intravascular Ultrasound
Malek Kass1, Michael P Love1, Amir Ravandi1
1St. Boniface Hospital, Section of Cardiology, Department of Medicine, University of Manitoba, Canada.
Insights
This study shows that complex coronary interventions can be performed without contrast dye, even in patients with severe kidney dysfunction. This zero-contrast approach is feasible and safe, preserving renal function post-procedure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Nephrology
Background:
- Severe kidney dysfunction poses significant risks for contrast-enhanced procedures in patients with acute coronary syndrome.
- Contrast media used in angiography and percutaneous coronary intervention can exacerbate renal impairment.
Observation:
- A 49-year-old female with severe kidney dysfunction presented with acute coronary syndrome and complex coronary artery disease.
- The patient underwent staged percutaneous coronary intervention using intravascular lithotripsy, fluoroscopy, and intravascular ultrasound without any contrast dye.
Findings:
- The zero-contrast percutaneous coronary intervention was technically successful.
- The patient experienced no deterioration in renal function post-procedure and was discharged 3 days later.
Implications:
- Zero-contrast percutaneous coronary intervention is a feasible and safe alternative for patients with severe renal dysfunction.
- This approach minimizes the risk of contrast-induced nephropathy in vulnerable patient populations.
- Further research should explore the broader application of zero-contrast techniques in complex coronary interventions.
Abstract:
A 49-year-old female with severe kidney dysfunction presented with an acute coronary syndrome. After angiography demonstrated severe disease in the left anterior descending and obtuse marginal arteries, she underwent staged percutaneous intervention with intravascular lithotripsy under fluoroscopic and intravascular ultrasound guidance with the use of zero contrast. She did well and went home 3 days post procedure with no deterioration in her renal function. This demonstrates the feasibility of complex coronary intervention with no contrast requirement.
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