title: Multivessel percutaneous coronary intervention without contrast agents.
abstract: Contrast-induced nephropathy (CIN) following coronary angiography is associated with significant morbidity and mortality. Contrast media volume is the key risk factor for CIN in patients with chronic kidney disease undergoing coronary angiography and interventions. Very often, coronary interventions are avoided in such high-risk patients because of possible significant adverse clinical outcomes. We present a case demonstrating use of intravascular ultrasound (IVUS) to guide multivessel percutaneous coronary intervention (PCI) performed without any contrast administration in a patient with extreme risk for CIN. With the availability of advanced imaging of the coronary arteries such as high definition IVUS, contrast free PCI is a feasible approach and is associated with significant advantages of reducing or eliminating the development of CIN following PCI. This case report highlights the key practical aspects of performing contrast-free PCI and the challenges associated with such approach. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Division of Interventional Cardiology, North Hills Hospital, North Richland Hills, Texas, 76180.
authors.forename: Venkatesan D
authors.initials: VD
authors.lastname: Vidi
authors.affiliation: Division of Cardiovascular Disease, University of California Irvine Medical Center, Orange, California, 92868.
authors.forename: Ailin
authors.initials: A
authors.lastname: Barseghian
authors.affiliation: Center for Heart and Vascular Health, Christiana Care Health System, Wilmington, Delaware, 19806.
authors.forename: Kirk N
authors.initials: KN
authors.lastname: Garratt
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media
keywords: contrast use during percutaneous coronary intervention; coronary intravascular ultrasound