Study of fluoroscopic landmarks in IVUS guided zero contrast PCI - A single centre experience

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dc.contributor.authorKhanolkar, Uday B.en_US
dc.contributor.authorBanotra, Pankajen_US
dc.contributor.authorMahala, Bijay Kumaren_US
dc.contributor.authorHegde, Nitin Kumaren_US
dc.contributor.authorJino, Blessvinen_US
dc.contributor.authorShetty, Devi Prasaden_US
dc.contributor.authorSangoi, Parin Chandrakanten_US
dc.date.accessioned2025-08-13T11:15:22Z
dc.date.available2025-08-13T11:15:22Z
dc.date.issued2025-04
dc.description.abstractIntroduction: Contrast induced nephropathy is third most common cause of renal insufficiency following percu- taneous coronary angioplasty (PCI) and patients with preexisting renal dysfunction are even at a higher risk for poor outcomes. With the advent of intravascular imaging, safety and efficacy of angioplasty can be improved significantly in these patients. Material and methods: This observational prospective study included 72 consecutive patients with CKD(eGFR ?45 ml/min/m2) and established CAD who underwent absolute zero contrast PCI at a single tertiary center.PCI was planned in patients with significant stenosis and indications for revascularization.All Procedures were performed under dry fluoroscopy and IVUS guidance without use of any contrast.Informed consent, clinical, procedural and follow-up data was collected and analysed. Results: Total 72 patients (90 vessels) with median age of 63 years and eGFR (34.1 ml/min/1.73 m2) underwent zero contrast PCI. Procedure was performed by Femoral (45.6 %)and radial (54.4%) route. Total 11 patients (15.3%) underwent left main stenting. Fluoroscopic landmarks such as side-branch wiring (71.1%),floating wire in aorta (22.2 %), calcifications (21.1%), bony landmarks such as ribs or vertebrae (45.5%) and Sternal wires/ clips (6.6%) were used in addition to IVUS to enable more accurate placement of stent.Technical and procedural success were achieved in 91.1% and 97.2% of patients.One patient died in hospital due to non-cardiac cause and one patient required hemodialysis.Post procedure at 48 hrs, there was no deterioration of renal function.On 3 months followup, there was no significant major adverse cardiovascular events (MACE). Conclusion: Our study shows that with the help of fluoroscopy landmarks and intravascular imaging, zero contrast PCI can be performed safely with good clinical outcomes in patients at risk of nephropathy.en_US
dc.identifier.affiliationsNarayana Institute of Cardiac Sciences, Bangalore, Indiaen_US
dc.identifier.affiliationsNICS, Bangalore, Indiaen_US
dc.identifier.affiliationsNICS, Bangalore, Indiaen_US
dc.identifier.affiliationsNICS, Bangalore, Indiaen_US
dc.identifier.affiliationsFellow Interventional Cardiology, NICS, Bangalore, Indiaen_US
dc.identifier.affiliationsNICS, Bangalore, Indiaen_US
dc.identifier.affiliationsFellow Interventional Cardiology, NICS, Bangalore, Indiaen_US
dc.identifier.citationKhanolkar Uday B., Banotra Pankaj, Mahala Bijay Kumar, Hegde Nitin Kumar, Jino Blessvin, Shetty Devi Prasad, Sangoi Parin Chandrakant. Study of fluoroscopic landmarks in IVUS guided zero contrast PCI - A single centre experience. Indian Heart Journal. 2025 Apr; 77(2): 78-83en_US
dc.identifier.issn0019-4832
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/253348
dc.languageenen_US
dc.publisherElsevieren_US
dc.relation.issuenumber2en_US
dc.relation.volume77en_US
dc.source.urihttps://doi.org/10.1016/j.ihj.2025.02.006en_US
dc.subjectContrast-induced acute kidney injuryen_US
dc.subjectChronic kidney diseaseen_US
dc.subjectIntravascular ultrasounden_US
dc.subjectPercutaneous coronary angioplastyen_US
dc.subjectGlomerular filtration rateen_US
dc.titleStudy of fluoroscopic landmarks in IVUS guided zero contrast PCI - A single centre experienceen_US
dc.typeJournal Articleen_US
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