Association of less-contrast media with clinical factors in elective percutaneous coronary intervention

Mukai, Yasuhiro; Sakakura, Kenichi; Yamamoto, Kei; Taniguchi, Yousuke; Tsukui, Takunori; Seguchi, Masaru; Wada, Hiroshi; Momomura, Shin‐ichi; Fujita, Hideo

doi:10.1007/s00380-019-01473-3

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…Our study did not yield a statistical difference between the two study groups in terms of mortality during hospitalization. A previous study examined the amount of contrast agents used during PCI and suggested the possibility of controlling the amount of contrast media when IVUS was utilized [8]. We examined the rates of AKI and did not observe a statistical difference between the two groups, even after applying propensity matching.…”

Section: Discussionmentioning

confidence: 96%

“…In the USA, the use of IVUS is limited due to particular concerns about the increased stent use; particularly, longer stenting duration that has been reported previously [7]. Some studies reported less contrast use when IVUS was utilized [8]. A recent study in Japan examined angiography-guided PCI versus IVUS-guided PCI in patients with acute myocardial infarction and concluded that the use of IVUS was associated with better in-hospital mortality [9].…”

Section: Introductionmentioning

confidence: 99%

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In-hospital outcomes of angiography versus intravascular ultrasound-guided percutaneous coronary intervention in ST-elevation myocardial infarction patients

Khalid

Patel

Amgai

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

In-hospital outcomes of angiography versus intravascular ultrasound-guided percutaneous coronary intervention in ST-elevation myocardial infarction patients

Khalid

Patel

Amgai

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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“…Coraz więcej badań wskazuje na korzyści z zastosowania tej metody u pacjentów z zawałem mięśnia sercowego z uniesieniem odcinka ST (STEMI) w porównaniu z obrazowaniem angiograficznym. Obrazowanie przy pomocy IVUS w czasie przezskórnej implantacji stentu (PCI) jest szczególnie istotne w naczyniach o skomplikowanej anatomii, pozwala zmniejszyć ilość kontrastu używanego w czasie zabiegu [2,4] oraz umożliwia potwierdzenie położenia stentu oraz jego optymalnego rozprężenia [2,5]. Dodatkowo, według ostatnich doniesień naukowych obrazowanie metodą IVUS wiąże się z mniejszym ryzykiem poważnych niepożądanych incydentów sercowych (MACE) [2,5].…”

Section: Wstępunclassified

“…Według ostatnich rekomendacji Polskiego Towarzystwa Kardiologicznego obrazowanie naczyń metodą IVUS może być przydatne w ,,identyfikacji przyczyn uszkodzenia nierozpoznanych w trakcie koronarografii, w szczególności jeśli podejrzewa się skrzeplinę, pęknięcie blaszki miażdżycowej, nadżerkę albo samoistne rozwarstwienie tętnicy wieńcowej (SCAD)'' [3] Według niektórych doniesień obrazowanie metodą IVUS w czasie PCI wiąże się z wyższym ryzykiem rozwarstwienia naczyń wieńcowych niż obrazowanie angiograficzne, jednak związek ten może raczej wynikać z SCAD objawiającego się jako STEMI niż jatrogennego uszkodzenia naczynia w czasie procedury [1]. Co więcej, niektóre badania wykazały redukcję ilości kontrastu wykorzystywanego podczas PCI obrazowanego IVUS i zmniejszenie ryzyka ostrego uszkodzenia nerek [4,5].…”

Section: Dyskusjaunclassified

Imaging in patients with ST-segment elevation myocardial infarction - a case report

Gniot

Jankiewicz²

2023

J Educ Health Sport

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Introduction and purpose: Intravascular ultrasound (IVUS) facilitates 3-dimensional visualization of the blood vessels. Nowadays, it becomes increasingly supportive in percutaneous coronary intervention (PCI) guiding in patients with acute myocardial infarction (AMI). This report presents IVUS-guided PCI performed on 43-year-old patient with ST-segment elevation myocardial infarction (STEMI). Brief description of the state of knowledge: IVUS is an established intracoronary imaging technique that can be used in patients with AMI. It allows assessment of the plaque nature, stent selection and optmisation. An increasing body of evidence shows that IVUS-guided PCI is correlated with reduction in number of major adverse cardiovascular events (MACE), stent thrombosis and with less contrast use. Studies show, that IVUS can be used in patient with STEMI, as it is presented in this report. Conclusion: This case illustrates IVUS-guided PCI performed on the patient with STEMI. It shows that it is crucial to consider using this technique in every patient with AMI, as it provides beneficial outcome of the treatment. It is particularly important in patients with complicated anatomy of the blood vessels and in patients with contraindications to the considerable contrast use.

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“…However, conventional coronary angiography (CCA) requires multidirectional views of both the left and right coronary arteries. It is also well known that the use of contrast medium and radiation can lead to adverse events with increased use [2][3][4][5][6]. Therefore, various techniques have been devised to reduce contrast medium volume and radiation exposure while maintaining diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction

et al. 2020

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Several studies have shown that dual-axis rotational coronary angiography (DARCA) reduces contrast medium volume and radiation exposure compared to conventional coronary angiography (CCA). However, there are no studies comparing the safety and usefulness of DARCA in primary percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the effects of DARCA on contrast medium volume, radiation exposure, time course of treatment, and adverse events in primary PCI for patients with STEMI. A total of 82 patients undergoing primary PCI were included in this study. Subjects were propensity matched to 41 patients in the CCA group and 41 in the DARCA group. Data were retrospectively collected from in-patient medical records and the contrast medium volume and radiation exposure (dose-area product, DAP) during the PCI procedure was compared between the two groups. Contrast medium volume [100.0 (82.5–115.0) vs 110 (102.5–127.5) ml, p = 0.018, r = 0.26] and DAP [113.4 (74.3–141.1) vs 138.1 (100.5–194.7) Gy cm2, p = 0.014, r = 0.27] were significantly lower in the DARCA group, compared with the CCA group. Door to device time (68.7 ± 26.1 vs 76.5 ± 44.2 min, p = 0.33) were comparable between the two groups. There were no adverse events requiring treatment reported in either groups. DARCA may reduce contrast medium volume and radiation exposure in primary PCI for patients with STEMI, and can be used safely, without delaying reperfusion of the infarct-related coronary artery.

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Association of less-contrast media with clinical factors in elective percutaneous coronary intervention

Cited by 5 publications

References 15 publications

In-hospital outcomes of angiography versus intravascular ultrasound-guided percutaneous coronary intervention in ST-elevation myocardial infarction patients

In-hospital outcomes of angiography versus intravascular ultrasound-guided percutaneous coronary intervention in ST-elevation myocardial infarction patients

Imaging in patients with ST-segment elevation myocardial infarction - a case report

Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction

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