Impact of minimum contrast media volumes during percutaneous coronary intervention for chronic total occlusion lesion.
Chronic total occlusion
Contrast-induced nephropathy
Percutaneous coronary intervention
Journal
Heart and vessels
ISSN: 1615-2573
Titre abrégé: Heart Vessels
Pays: Japan
ID NLM: 8511258
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
30
11
2022
accepted:
19
04
2023
medline:
27
7
2023
pubmed:
13
6
2023
entrez:
13
6
2023
Statut:
ppublish
Résumé
Contrast media exposure is associated with contrast-induced nephropathy (CIN) following percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). Aim of this study is to assess the utility of minimum contrast media volume (CMV ≤ 50 mL) during CTO-PCI for CIN prevention in patients with chronic kidney disease (CKD). We extracted data from the Japanese CTO-PCI expert registry; 2863 patients with CKD who underwent CTO-PCI performed from 2014 to 2020 were divided into two groups: minimum CMV (n = 191) and non-minimum CMV groups (n = 2672). CIN was defined as an increased serum creatinine level of ≥ 25% and/or ≥ 0.5 mg/dL compared with baseline levels within 72 h of the procedure. In the minimum CMV group, the CIN incidence was lower than that in the non-minimum CMV group (1.0% vs. 4.1%; p = 0.03). Patient success rate was higher and complication rate was lower in the minimum CMV group than in the non-minimum CMV group (96.8% vs. 90.3%; p = 0.02 and 3.1% vs. 7.1%; p = 0.03). In the minimum CMV group, the primary retrograde approach was more frequent in the case of J-CTO = 1,2 and 3-5 groups compared to that in non-minimum CMV-PCI group (J-CTO = 0; 11% vs. 17.7%, p = 0.06; J-CTO = 1; 22% vs. 35.8%, p = 0.01; J-CTO = 2; 32.4% vs. 46.5%, p = 0.01; and J-CTO = 3-5; 44.7% vs. 80.0%, p = 0.02). Minimum CMV-PCI for CTO in CKD patients could reduce the incidence of CIN. The primary retrograde approach was observed to a greater extent in the minimum CMV group, especially in cases of difficult CTO.
Identifiants
pubmed: 37310464
doi: 10.1007/s00380-023-02270-9
pii: 10.1007/s00380-023-02270-9
doi:
Substances chimiques
Contrast Media
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1108-1116Informations de copyright
© 2023. Springer Nature Japan KK, part of Springer Nature.
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