Key result
Zero-contrast PCI guided by IVUS achieves 100% procedural success without MACE or renal decline.
Why the study?
Does zero contrast PCI using IVUS and physiological guidance preserve renal function and prevent the need for RRT in patients with advanced CKD requiring revascularization?
Observational
Does zero contrast PCI using IVUS and physiological guidance preserve renal function and prevent the need for RRT in patients with advanced CKD requiring revascularization?
Answers are grounded in this paper and cite their sources.
Zero contrast PCI using IVUS and physiological guidance is feasible and safe in patients with advanced CKD, preserving renal function without requiring renal replacement therapy.
AIMS: The feasibility, safety, and clinical utility of percutaneous coronary intervention (PCI) without radio-contrast medium in patients with advanced chronic kidney disease (CKD) are unknown. In this series, we investigated a specific strategy for 'zero contrast' PCI with the aims of preserving renal function and preventing the need for renal replacement therapy (RRT) in patients with advanced CKD. METHODS AND RESULTS: ] who had clinical indication for PCI based on a prior minimal contrast coronary angiogram were included. Zero contrast PCI was performed at least 1 week after diagnostic angiography using real-time intravascular ultrasound (IVUS) guidance, with pre- and post-PCI measurements of fractional flow reserve and coronary flow reserve to confirm physiological improvement. This approach resulted in successful PCI, no major adverse cardiovascular events and preservation of renal function without the need for RRT within a follow-up time of 79 days (IQR 33-207) in all patients. CONCLUSION: In patients with advanced CKD who require revascularization, PCI may safely be performed without contrast using IVUS and physiological guidance with high procedural success and without complications.
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Ali et al. (2016) conducted an observational in Advanced chronic kidney disease (CKD). Zero contrast PCI using IVUS and physiological guidance was evaluated on Successful PCI, no major adverse cardiovascular events, and preservation of renal function without the need for RRT. Zero contrast PCI using IVUS and physiological guidance resulted in successful PCI, no major adverse cardiovascular events, and preservation of renal function in 100% of patients.
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