Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects

Jerzy Sacha; Marek Gierlotka; Przemysław Lipski; Piotr Feusette; Dariusz Dudek

doi:10.5114/aic.2019.86008

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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abstract:

Original paper

Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects

Jerzy Sacha

^{1, 2}

,

Marek Gierlotka

¹

,

Przemysław Lipski

¹

,

Piotr Feusette

¹

,

Dariusz Dudek

³

Department of Cardiology, University Hospital, Faculty of Natural Sciences and Technology, University of Opole, Opole, Poland
Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland

Adv Interv Cardiol 2019; 15, 2 (56): 137–142

DOI: https://doi.org/10.5114/aic.2019.86008

Online publish date: 2019/06/26

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AMA

Sacha J, Gierlotka M, Lipski P, Feusette P, Dudek D. Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2019;15(2):137-142. doi:10.5114/aic.2019.86008.

APA

Sacha, J., Gierlotka, M., Lipski, P., Feusette, P.,  & Dudek, D. (2019). Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 15(2), 137-142. https://doi.org/10.5114/aic.2019.86008

Chicago

Sacha, Jerzy, Marek Gierlotka, Przemysław Lipski, Piotr Feusette,  and Dariusz Dudek. 2019. "Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 15 (2): 137-142. doi:10.5114/aic.2019.86008.

Harvard

Sacha, J., Gierlotka, M., Lipski, P., Feusette, P.,  and Dudek, D. (2019). Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 15(2), pp.137-142. https://doi.org/10.5114/aic.2019.86008

MLA

Sacha, Jerzy et al. "Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 15, no. 2, 2019, pp. 137-142. doi:10.5114/aic.2019.86008.

Vancouver

Sacha J, Gierlotka M, Lipski P, Feusette P, Dudek D. Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2019;15(2):137-142. doi:10.5114/aic.2019.86008.

Introduction
Zero-contrast percutaneous coronary intervention (zero-PCI) is a new method for prevention of contrast-induced acute kidney injury (AKI) in patients with chronic kidney disease (CKD). However, evidence for its feasibility, safety and clinical utility is limited to reports of single cases or series of patients.

Aim
To present outcomes of zero-PCI in patients with severe CKD, including hemodialysis subjects, who were treated with this procedure in order to preserve their renal function.

Material and methods
Twenty-nine zero-PCIs were performed, mostly as a staged procedure, in 20 patients with advanced CKD. In this group, 4 patients were treated with hemodialysis but presented preserved residual renal function. The estimated median risk for contrast-induced AKI in non-dialysis patients was 26% (26–57%).

Results
Zero-PCI was feasible in each intended patient, including those with complex left main stenosis or lesion within a saphenous vein graft, and there was no specific complication associated with this technique. After the procedure, the factual AKI prevalence was 10% and no patient required renal replacement therapy. Three of 4 hemodialysis patients preserved their residual renal function. During the median follow-up of 3.2 (1.2–5.3) months no patient experienced an acute coronary event or required revascularization.

Conclusions
Zero-PCI is a safe and promising method to preserve renal function in patients with CKD and hemodialysis patients. Such an approach is feasible even in complex coronary lesions and yields good clinical outcomes in mid-term observation.

keywords:

Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects

Jerzy Sacha 1, 2 , Marek Gierlotka 1 , Przemysław Lipski 1 , Piotr Feusette 1 , Dariusz Dudek 3

renal insufficiency, contrast-induced nephropathy, acute kidney injury, zero-contrast percutaneous coronary intervention

Jerzy Sacha

^{1, 2}

,

Marek Gierlotka

¹

,

Przemysław Lipski

¹

,

Piotr Feusette

¹

,

Dariusz Dudek

³