Intravascular Ultrasound Guidance to Minimize the Use of Iodine Contrast in Percutaneous Coronary Intervention
| Autor: | Marco Antonio Perin, Pedro A. Lemos, Cristiano Guedes, Carlos M. Campos, Celso Kiyochi Takimura, Elazer R. Edelman, Paulo R. Soares, Augusto C. Lopes, José Mariani, Roberto Kalil-Filho, Andre G. Spadaro, Expedito E. Ribeiro, Patrick W. Serruys, Silvio Zalc, Antonio Esteves Filho |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment Percutaneous coronary intervention Stent 030204 cardiovascular system & hematology 3. Good health 03 medical and health sciences surgical procedures operative 0302 clinical medicine Interquartile range Angioplasty Angiography Intravascular ultrasound Conventional PCI medicine Clinical endpoint cardiovascular diseases 030212 general & internal medicine Radiology business Cardiology and Cardiovascular Medicine |
| Zdroj: | JACC: Cardiovascular Interventions. 7(11):1287-1293 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2014.05.024 |
| Popis: | Objectives The aim of this study was to evaluate the impact of intravascular ultrasound (IVUS) guidance on the final volume of contrast agent used in patients undergoing percutaneous coronary intervention (PCI). Background To date, few approaches have been described to reduce the final dose of contrast agent in PCIs. We hypothesized that IVUS might serve as an alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of iodine contrast. Methods A total of 83 patients were randomized to angiography-guided PCI or IVUS-guided PCI; both groups were treated according to a pre-defined meticulous procedural strategy. The primary endpoint was the total volume contrast agent used during PCI. Patients were followed clinically for an average of 4 months. Results The median total volume of contrast was 64.5 ml (interquartile range [IQR]: 42.8 to 97.0 ml; minimum, 19 ml; maximum, 170 ml) in the angiography-guided group versus 20.0 ml (IQR: 12.5 to 30.0 ml; minimum, 3 ml; maximum, 54 ml) in the IVUS-guided group (p Conclusions Thoughtful and extensive use of IVUS as the primary imaging tool to guide PCI is safe and markedly reduces the volume of iodine contrast compared with angiography-alone guidance. The use of IVUS should be considered for patients at high risk of contrast-induced acute kidney injury or volume overload undergoing coronary angioplasty. (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy [MOZART]; NCT01947335 ) |
| Databáze: | OpenAIRE |
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