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In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
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Zero contrast optical coherence tomography-guided percutaneous coronary intervention in patients with non-ST segment

Zheng-Yu Liu1,2, Zi-Hui Yin3, Cheng-Yang Liang4

  • 1Department of Cardiology, Hunan Provincial People's Hospital, Changsha, Hunan, China.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 25, 2021
PubMed

Insights

Ultra-low contrast percutaneous coronary intervention (PCI) is safe for non-ST-elevated myocardial infarction (non-STEMI) patients with chronic kidney disease (CKD). This strategy preserves renal function and shows no major adverse events at 90 days.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • The safety and efficacy of percutaneous coronary intervention (PCI) using minimal contrast media in patients with non-ST-elevated myocardial infarction (non-STEMI) and chronic kidney disease (CKD) remain largely uncharacterized.
  • Assessing renal function preservation and short-term clinical outcomes is critical for this high-risk patient population undergoing revascularization.

Purpose of the Study:

  • To evaluate a strategy of ultra-low volume contrast PCI aimed at preserving renal function in non-STEMI patients with CKD.
  • To observe the 90-day clinical endpoint in this cohort.

Main Methods:

  • A prospective study included 29 non-STEMI patients with CKD (eGFR ≤60 mL/min/1.73 m²).
  • Ultra-low volume contrast PCI was performed using minimal contrast coronary angiography and zero-contrast optical coherence tomography (OCT) guidance.
  • Quantitative flow ratio (QFR) was used for pre-perfusion assessment and to verify procedural improvement.

Main Results:

  • The study included patients with a median creatinine of 2.1 mg/dL and mean eGFR of 48 mL/min/1.73 m².
  • Optical coherence tomography (OCT) identified abnormalities in 52% of cases post-dilation.
  • No significant changes in creatinine or eGFR were observed short- or long-term, and no major adverse events occurred.

Conclusions:

  • Ultra-low contrast PCI guided by QFR and zero-contrast OCT is a safe and feasible strategy for non-STEMI patients with high-risk CKD.
  • This approach can be performed without major adverse events, suggesting potential for renal function preservation in this vulnerable group.
Abstract

Keywords:
chronic kidney diseasecontrast-induced nephropathyoptical coherence tomographypercutaneous coronary interventionpoststent abnormalitiesquantitative flow ratio

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