Rationale and design of the Dynamic Coronary Roadmap for Contrast Reduction (DCR4Contrast) in PCI randomized...

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Increasing complexity of percutaneous coronary interventions (PCI) necessitates advanced navigation tools.
• Contrast-induced nephropathy (CIN) is a significant complication impacting prognosis after PCI.
• Minimizing contrast volume during PCI is crucial for improving patient outcomes and safety.

Purpose of the Study:

• To evaluate if Dynamic Coronary Roadmap (DCR) use reduces total iodinated contrast volume during PCI.
• To assess the potential of DCR to decrease the risk of CIN in patients undergoing PCI.
• To enhance the safety of PCI procedures through reduced contrast administration.

Main Methods:

• A multi-center, prospective, unblinded, 1:1 randomized controlled trial (DCR4Contrast).
• Comparison of PCI performed with DCR guidance versus PCI without DCR guidance.
• Primary endpoint: total undiluted iodinated contrast volume administered during PCI.

Main Results:

• The study is ongoing, with 346 out of 394 planned subjects enrolled as of November 14, 2022.
• Analysis of contrast volume reduction is pending full enrollment and data collection.
• The potential for DCR to spare contrast is under investigation.

Conclusions:

• The DCR navigation support tool shows potential for reducing iodinated contrast volume in PCI.
• Reduced contrast administration via DCR may lower the incidence of CIN.
• DCR technology may contribute to increased safety in percutaneous coronary interventions.