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Zero contrast optical coherence tomography‐guided percutaneous coronary intervention in patients with non‐ST segment elevation myocardial infarction and chronic kidney disease
Author(s) -
Liu ZhengYu,
Yin Zihui,
Liang ChengYang,
He Jing,
Wang ChangLu,
Peng Xiang,
Zhang Yu,
Zheng ZhaoFen,
Pan HongWei
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29655
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , cardiology , myocardial infarction , kidney disease , renal function , contrast induced nephropathy , revascularization , creatinine , optical coherence tomography , radiology
Objectives To investigate a strategy for ultra‐low volume contrast percutaneous coronary intervention (PCI) with the aims of preserving renal function and observing the 90‐day clinical endpoint in patients with non‐ST‐elevated myocardial infarction (non‐STEMI) and chronic kidney disease (CKD). Background The feasibility, safety, and clinical utility of PCI with ultra‐low radio‐contrast medium in patients with non‐STEMI and CKD are unknown. Methods A total of 29 patients with non‐STEMI and CKD (estimated glomerular filtration rate [eGFR] of ≤60 ml/min/1.73 m 2 ) were included. Ultra‐low volume contrast PCI was performed after minimal contrast coronary angiography using zero contrast optical coherence tomography (OCT) guidance. Pre‐ and post‐PCI angiographic measurements were performed using quantitative flow ratio (QFR) for pre‐perfusion assessment and verifying improvement. Results The median creatinine level was 2.1 (inter‐quartile range 1.8–3.3), and mean eGFR was 48 ± 8 ml/min/1.73 m 2 pre‐PCI. During the PCI procedure, OCT revealed 15 (52%) cases of abnormalities post‐dilation. There was no significant change in the creatinine level and eGFR in the short‐ or long‐term, and no major adverse events were observed. Conclusion In non‐STEMI patients with high‐risk CKD who require revascularization, QFR and no contrast OCT‐guided ultra‐low contrast PCI may be performed safely without major adverse events.