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Updated: Oct 26, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

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Zero-Contrast Multivessel Revascularization for Acute Coronary Syndrome in a Patient With Chronic Kidney Disease

Mahesh V Madhavan1,2, Megha Prasad1,2, Khady N Fall1

  • 1NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Zero-contrast percutaneous coronary intervention offers potential benefits for patients with chronic kidney disease undergoing treatment for acute coronary syndrome. This approach may reduce adverse events associated with traditional contrast media in high-risk patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Patients with chronic kidney disease (CKD) face increased risks from contrast media used in coronary angiography and percutaneous coronary intervention (PCI).
  • Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) requires timely intervention, often involving contrast-enhanced procedures.

Observation:

  • A case report details a patient with CKD and NSTE-ACS who underwent a zero-contrast multivessel PCI.
  • This approach aimed to mitigate the risks of contrast-induced nephropathy and other adverse events.

Findings:

  • Zero-contrast multivessel PCI was successfully performed in a patient with CKD presenting with NSTE-ACS.
  • The procedure demonstrated the feasibility and potential advantages of avoiding contrast media in this high-risk population.

Implications:

  • Zero-contrast PCI may be a viable and safer alternative for select CKD patients undergoing coronary interventions.
  • Further research is warranted to establish the broader efficacy and safety of contrast-sparing techniques in managing acute coronary syndromes in patients with renal impairment.

Keywords:
CAD, coronary artery diseaseCKD, chronic kidney diseaseCSA, cross-sectional areaISR, in-stent restenosisIVUS, intravascular ultrasoundLAD, left anterior descendingLCX, left circumflexMLD, minimal lumen diameterNSTEACS, non–ST-segment elevation acute coronary syndromeOM, obtuse marginalPCI, percutaneous coronary interventionRCA, right coronary arterycoronary angiographyiFR, instantaneous wave-free ratiointravascular ultrasoundpercutaneous coronary intervention

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