High Risk Percutaneous Coronary Intervention of Left Main Bifurcation Stenosis in a Peritoneal Dialysis Patient

Area of Science:

• Cardiology
• Nephrology

Background:

• Complex coronary artery disease (CAD) is a major cause of mortality in end-stage renal disease (ESRD) patients.
• Patients with ESRD, particularly those on peritoneal dialysis, are often excluded from clinical trials, limiting treatment data.

Observation:

• A case report of a patient on peritoneal dialysis with complex left main bifurcation stenosis.
• The patient received dual antiplatelet therapy (DAPT) with Prasugrel and acetylsalicylic acid prior to the procedure.

Findings:

• Successful high-risk percutaneous coronary intervention (PCI) was performed using a "double kiss crush" bifurcation stenting technique.
• This approach demonstrates a potential treatment strategy for complex CAD in ESRD patients.

Implications:

• Provides valuable data on managing complex CAD in a high-risk, often underrepresented patient population.
• Contributes to understanding the safety and efficacy of potent DAPT in ESRD patients, balancing ischemia and bleeding risks.
• Advances PCI techniques for challenging coronary anatomies in vulnerable patient groups.