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Enhanced stent visualization system for percutaneous coronary intervention in patients with chronic kidney disease:

Yunpeng Tian1, Xiangdong Zhao1, Yang Yang1

  • 1Department of Cardiology, Tianjin First Central Hospital, Tianjin, China.

BMC Cardiovascular Disorders
|November 15, 2022
PubMed

Insights

Enhanced stent visualization (ESV) systems significantly reduce contrast media volume and radiation dose during percutaneous coronary intervention (PCI). This is particularly beneficial for patients with chronic kidney disease (CKD), potentially lowering renal impairment risk.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Nephrology

Background:

  • Coronary heart disease (CHD) and chronic kidney disease (CKD) share pathological pathways.
  • Iodinated contrast media used in angiography can cause contrast-associated acute kidney injury (CA-AKI), worsening CKD.
  • The impact of enhanced stent visualization (ESV) systems on contrast media and radiation dose in PCI, especially for CKD patients, requires further investigation.

Purpose of the Study:

  • To evaluate the effect of ESV systems on contrast media volume and radiation dose during percutaneous coronary intervention (PCI).
  • To assess the benefits of ESV systems in patients with chronic kidney disease (CKD) undergoing PCI.

Main Methods:

  • Retrospective analysis of 124 patients with acute coronary syndrome undergoing PCI.
  • Patients were divided into an ESV-guided group (n=64) and an angiography-guided group (n=60).
  • Procedural parameters including contrast media volume, radiation exposure (Air Kerma and Dose Area Product), and procedure time were recorded and analyzed.

Main Results:

  • The ESV-guided group showed a significant reduction in contrast media volume (132.6 ± 22.3 ml vs. 174.7 ± 29.6 ml, p=0.0001).
  • Radiation exposure was significantly lower in the ESV group (Air Kerma: p=0.002, Dose Area Product: p=0.030).
  • Procedure time was also reduced in the ESV group (53.06 ± 21.20 min vs. 72.00 ± 30.55 min, p=0.01).

Conclusions:

  • Enhanced stent visualization (ESV) systems are associated with reduced contrast media usage, radiation dose, and procedure time during PCI.
  • Subgroup analysis confirmed these benefits in patients with CKD.
  • ESV-guided PCI offers potential benefits for reducing renal impairment and mitigating CKD progression in CHD patients with CKD.
Abstract

Keywords:
Chronic kidney diseaseContrast mediaEnhanced stent visualization systemPercutaneous coronary interventionRadiation

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