Abstract
Individuals with advanced chronic kidney disease (CKD) and coronary artery disease
are often denied percutaneous coronary intervention (PCI) because of an aversion to
the risk of contrast-induced nephropathy. We present the case of a 76-year-old man
with stage 4 CKD requiring coronary revascularization. Zero-contrast PCI was successfully
performed using dextran-based optical coherence tomography (OCT) guidance. Our report
suggests the feasibility of dextran-based, OCT-guided, zero-contrast PCI in patients
with advanced CKD. Further studies should evaluate the safety and efficacy of this
novel approach.
Résumé
Les individus atteints de néphropathie chronique (NPC) de stade avancé et de coronaropathie
se voient souvent refuser l’intervention coronarienne percutanée (ICP) en raison d’une
aversion pour le risque de néphropathie induite par les produits de contraste. Nous
présentons le cas d’un homme de 76 ans atteints d’une NPC de stade 4 pour laquelle
une revascularisation coronarienne est nécessaire. L’ICP sans injection de produit
de contraste a été réussie grâce au guidage par tomographie par cohérence optique
(TCO) au dextrane. Notre rapport illustre la faisabilité de l’ICP sans injection de
produit de contraste guidée par TCO au dextrane chez les patients atteints d’une NPC
de stade avancé. Des études portant sur l’évaluation de l’innocuité et de l’efficacité
de cette nouvelle approche devraient être réalisées.
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References
- Influence of renal function on the effects of early revascularization in non-ST-elevation myocardial infarction: data from the Swedish web-system for Enhancement and Development of Evidence-based care in HEART disease evaluated according to recommended therapies (SWEDEHEART).Circulation. 2009; 120: 851-858
- Contemporary incidence, predictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry.JACC Cardiovasc Interv. 2014; 7: 1-9
- Intravascular ultrasound guidance to minimize the use of iodine contrast in percutaneous coronary intervention: the MOZART (Minimizing cOntrast utiliZationWith IVUS Guidance in coRonary angioplasTy) randomized controlled trial.JACC Cardiovasc Interv. 2014; 7: 1287-1293
- Imaging- and physiology-guided percutaneous coronary intervention without contrast administration in advanced renal failure: a feasibility, safety, and outcome study.Eur Heart J. 2016; 37: 3090-3095
- Optical coherence tomography-guided percutaneous coronary intervention in pre-terminal chronic kidney disease with no radio-contrast administration.Eur Heart J. 2016; 37: 1059
Article info
Publication history
Published online: November 22, 2017
Accepted:
November 13,
2017
Received:
October 18,
2017
Footnotes
See page 342.e3 for disclosure information.
Identification
Copyright
© 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
