Role of intravascular ultrasound in minimizing the use of contrast in Percutaneous coronary intervention in patients with chronic stable angina and chronic kidney disease stageIII

Authors

1 Department of cardiology, Faculty of Medicine , Al-Azhar University, Cairo, Egypt.

2 Department of cardiology, Faculty of Medicine , Al-Azhar University, Cairo, Egypt

3 Internal medicine and nephrology department, faculty of medicine , Al-Azhar university, Cairo, Egypt

Abstract

Background: Percutaneous coronary procedures (PCIs) are frequently guided by intravascular ultrasonography (IVUS) (PCIs). because it can precisely measure the size of the lumen, plaque, and vessel. The aim of this work was to evaluate role of intravascular ultrasound in minimizing the use of contrast in PCI in patients with chronic stable angina and chronic kidney disease stage III and incidence of acute kidney injury after IVUS based PCI and angiographic based PCI in chronic kidney disease stage III patients. Methods: 50 patients with stage III chronic renal disease and chronic stable angina, both diabetic and non-diabetic, were enrolled in this prospective comparative cohort study. Patients were split into two equally sized groups: Group (A) underwent PCI using angiography regardless of whether they had diabetes, while group (B) underwent PCI using IVUS regardless of whether they had diabetes. Results: The incidence of nephropathy in diabetic patients was significantly higher compared to the non- diabetic patients (P value = 0.035). Post dilatation and stent diameter were significantly higher in group B compared to group A (P value < 0.001, 0.002 respectively) and type of lesion was significantly different between both groups (P value Diabetes was a major predictor of nephropathy and considerably increased the incidence of nephropathy in diabetic patients compared to non-diabetic patients.

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