Zero-Contrast Left Main Bifurcation PCI in an Elderly Patient with Chronic Kidney Disease

Area of Science:

• Cardiology
• Nephrology
• Interventional Cardiology

Background:

• Chronic kidney disease (CKD) increases risks for patients undergoing percutaneous coronary intervention (PCI).
• Contrast-induced acute kidney injury (AKI) is a significant complication following coronary angiography and PCI.
• Left main bifurcation lesions present complex challenges in PCI procedures.

Observation:

• A case study involving an 82-year-old male with non-ST elevation myocardial infarction (NSTEMI).
• The patient had pre-existing CKD and developed contrast-induced AKI after initial coronary angiography.
• The patient underwent a zero-contrast left main bifurcation PCI procedure.

Findings:

• Zero-contrast PCI was successfully performed for left main bifurcation disease.
• The procedure avoided further nephrotoxic contrast administration.
• The patient remained stable and asymptomatic at nine months post-procedure.

Implications:

• Zero-contrast PCI is a viable and potentially safer alternative for high-risk patients with CKD.
• This technique may reduce the incidence of contrast-induced AKI in vulnerable populations.
• Further research into zero-contrast techniques for complex PCI is warranted.