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Updated: Aug 10, 2026
06:02
Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
Long-term Outcomes of Renal Function Following CTO PCI: Insights on Contrast Exposure
Federica B B Testerini1, Francesco Giangiacomi2, Carlo Zivelonghi3
1Hartcentrum, Ziekenhuis Aan de Stroom (ZAS) Middelheim, Antwerpen, Belgium; IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy.
The American Journal of Cardiology
|August 8, 2026
Summary
Procedural contrast volume does not impact long-term kidney function after chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Patient factors, not contrast exposure, are the main drivers of persistent kidney dysfunction following CTO-PCI.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Long-term renal outcomes after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) are not fully understood.
- The role of contrast volume in post-PCI kidney function decline is debated, especially beyond the acute phase.
Purpose of the Study:
- To investigate the association between procedural contrast volume and long-term renal function deterioration in patients undergoing CTO-PCI.
- To identify predictors of persistent kidney dysfunction after CTO-PCI.
Main Methods:
- Retrospective cohort study of 275 patients undergoing CTO-PCI with creatinine follow-up ≥90 days.
- Endpoints included persistent kidney dysfunction (≥25% eGFR decline), KDIGO stage progression, and rapid progression.
- Contrast volume analyzed continuously and by quartiles; multivariable regression and sensitivity analyses performed.
Main Results:
- Median follow-up was 3.3 years; 52.4% experienced persistent kidney dysfunction.
- Procedural contrast volume was not independently associated with kidney dysfunction or KDIGO stage progression.
- Patient factors (age, male sex, hypertension, diabetes) were independent predictors of renal decline.
Conclusions:
- Contrast volume is not independently linked to long-term renal deterioration after CTO-PCI.
- Patient-related factors, rather than procedural contrast exposure, are primary drivers of kidney function decline.
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