title: Prevention of contrast-induced acute kidney injury after percutaneous coronary intervention for chronic total coronary occlusions.
abstract: Chronic total occlusions (CTOs) represent a major challenge in percutaneous coronary revascularization. The recent advances in strategies and techniques and the development of dedicated equipment, such as microcatheters and wires, have resulted in considerably higher success rates. Although successful CTO recanalization is associated with significant clinical benefits, including improvement of angina, quality of life, reduced need for surgical revascularization, and improvement of left ventricular function, CTO procedures may require prolonged x-ray exposure and use of larger volumes of contrast compared with non-CTO procedures. Large volumes of contrast medium have been associated with increased rates of contrast-induced acute kidney injury (CI-AKI) and adverse short- and long-term outcomes. Application of specific measures and algorithms should be considered by all CTO operators to prevent CI-AKI.
authors: Department of Cardiology, London Chest Hospital, Barts Health NHS Trust, London, United Kingdom. Electronic address: antonispav@yahoo.com.
authors: Antonis N
authors: AN
authors: Pavlidis
authors: Department of Cardiology, London Chest Hospital, Barts Health NHS Trust, London, United Kingdom.
authors: Daniel A
authors: DA
authors: Jones
authors: Department of Cardiology, The Heart Hospital, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
authors: Alex
authors: A
authors: Sirker
authors: Department of Cardiology, London Chest Hospital, Barts Health NHS Trust, London, United Kingdom.
authors: Anthony
authors: A
authors: Mathur
authors: Department of Cardiology, London Chest Hospital, Barts Health NHS Trust, London, United Kingdom.
authors: Elliot J
authors: EJ
authors: Smith
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003287:Contrast Media / Q000009:adverse effects*; D054059:Coronary Occlusion / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media