Zero contrast optical coherence tomography-guided percutaneous coronary intervention for in-stent restenosis of the saphenous vein graft using a non-contrast flush medium

Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S492-S495. doi: 10.1016/j.ihj.2018.11.001. Epub 2018 Nov 9.

Abstract

Percutaneous coronary intervention (PCI) is often denied for individuals with coronary artery disease who are prone to develop contrast-induced acute kidney injury. We report a 73-year-old, stage 3 chronic kidney disease patient (CKD), who underwent coronary artery bypass surgery and saphenous vein graft (SVG) stenting in the past, presented with in-stent restenosis (ISR) of SVG stent. Zero contrast optical coherence tomography (OCT) guided-PCI was successfully performed using low molecular weight dextran-40 (LMWD-40) as the flush medium. Our report suggests the safety and feasibility of LMWD-40-based OCT-guided zero contrast PCI in ISR of SVG in a CKD patient, although further prospective studies are needed to evaluate this technique.

Keywords: Chronic kidney disease; Contrast induced-Acute kidney injury; Dextran-40; Optical coherence tomography; Percutaneous coronary intervention; Zero contrast.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aged
  • Contrast Media
  • Coronary Restenosis / diagnosis
  • Coronary Restenosis / surgery*
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / surgery
  • Humans
  • Male
  • Percutaneous Coronary Intervention / methods*
  • Saphenous Vein / transplantation*
  • Stents / adverse effects*
  • Tomography, Optical Coherence / methods*

Substances

  • Contrast Media