Key result
DK-crush PCI with prasugrel achieves complication-free 6-month outcomes in high-risk peritoneal dialysis patient.
Why the study?
Patients with end-stage renal disease on peritoneal dialysis are often excluded from randomized trials, creating uncertainty about optimal PCI treatment and DAPT safety in this high-risk group.
Case Report (n=1)
No
This case demonstrates the feasibility of complex PCI (double kiss crush) and the use of potent dual antiplatelet therapy in a high-risk patient with end-stage renal disease on peritoneal dialysis.
Answers are grounded in this paper and cite their sources.
Supports feasibility of complex PCI with prasugrel in peritoneal dialysis; hypothesis-generating and should not yet change practice.
Complex coronary artery disease is the leading cause of death in patients with end-stage renal disease. We report a case of a patient on peritoneal dialysis, preloaded with Prasugrel and acetylsalicylic acid as а potent dual antiplatelet therapy (DAPT). The patient underwent a high-risk percutaneous coronary intervention (PCI) due to bifurcation stenosis of the left main stem branch. A "double kiss crush" bifurcation stenting technique was performed. This case provides additional data about the treatment of this group of patients, a group that is often excluded from randomized control trials, but is frequently encountered in cardiovascular practice. Furthermore, it helps to advance PCI treatment along with exploring the safety of potent DAPT in a group that is susceptible to both ischemia and bleeding, thus presenting a great challenge in the decision for treatment.
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Bushljetikj et al. (2021) conducted a case report in Left main bifurcation stenosis and end-stage renal disease on peritoneal dialysis (n=1). Percutaneous coronary intervention (Double Kiss crush technique) and Prasugrel was evaluated on Procedural success and clinical outcomes at 6 months. High-risk percutaneous coronary intervention using the Double Kiss crush technique and Prasugrel was successfully performed in a peritoneal dialysis patient, with no complications at 6 months.
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