Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case report
BackgroundContrast-induced nephropathy (CIN) is a risk in angiographic procedures, especially for patients with acute kidney injury (AKI). To mitigate this risk, ultra-low contrast percutaneous coronary intervention (ULC-PCI) has been developed, which minimizes the use of contrast agents.Case summar...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1607466/full |
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| author | Arwin Saleh Mangkuanom Revan Satrio Brian Mendel Doni Firman Nanda Iryuza Amir Aziz Alkatiri |
| author_facet | Arwin Saleh Mangkuanom Revan Satrio Brian Mendel Doni Firman Nanda Iryuza Amir Aziz Alkatiri |
| author_sort | Arwin Saleh Mangkuanom |
| collection | DOAJ |
| description | BackgroundContrast-induced nephropathy (CIN) is a risk in angiographic procedures, especially for patients with acute kidney injury (AKI). To mitigate this risk, ultra-low contrast percutaneous coronary intervention (ULC-PCI) has been developed, which minimizes the use of contrast agents.Case summaryA 54-year-old woman with a history of AKI from a prior percutaneous coronary intervention (PCI) was found to have coronary artery disease with three vessels disease and chronic total occlusion in the right coronary artery. To minimize contrast use, she underwent ultra-low contrast PCI using the “microcatheter injection” technique, with only 5 cc of contrast used during the procedure. At one-year follow-up, the patient's LVEF improved from 33% to 56%, symptoms resolved with no chest pain. Her estimated glomerular filtration rate (eGFR) showed no significant decrease, since serum creatinine increased slightly from 1.59 mg/dl to 1.61 mg/dl. and eGFR decreased from 39 to 38 ml/min/1.73 m2 in 72 h.ConclusionsThe microcatheter injection technique may serve as a viable strategy for percutaneous coronary intervention (PCI) in patients with eGFR < 30 ml/min/1.73 m2 or history of contrast-induced nephropathy. |
| format | Article |
| id | doaj-art-59bc9d87485e44d8922d2ef2bd0b719f |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-59bc9d87485e44d8922d2ef2bd0b719f2025-08-20T02:41:34ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.16074661607466Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case reportArwin Saleh Mangkuanom0Revan Satrio1Brian Mendel2Doni Firman3Nanda Iryuza4Amir Aziz Alkatiri5Invasive Diagnostic and Non Surgical Intervention Division, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaInvasive Diagnostic and Non Surgical Intervention Division, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaInvasive Diagnostic and Non Surgical Intervention Division, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaInvasive Diagnostic and Non Surgical Intervention Division, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaBackgroundContrast-induced nephropathy (CIN) is a risk in angiographic procedures, especially for patients with acute kidney injury (AKI). To mitigate this risk, ultra-low contrast percutaneous coronary intervention (ULC-PCI) has been developed, which minimizes the use of contrast agents.Case summaryA 54-year-old woman with a history of AKI from a prior percutaneous coronary intervention (PCI) was found to have coronary artery disease with three vessels disease and chronic total occlusion in the right coronary artery. To minimize contrast use, she underwent ultra-low contrast PCI using the “microcatheter injection” technique, with only 5 cc of contrast used during the procedure. At one-year follow-up, the patient's LVEF improved from 33% to 56%, symptoms resolved with no chest pain. Her estimated glomerular filtration rate (eGFR) showed no significant decrease, since serum creatinine increased slightly from 1.59 mg/dl to 1.61 mg/dl. and eGFR decreased from 39 to 38 ml/min/1.73 m2 in 72 h.ConclusionsThe microcatheter injection technique may serve as a viable strategy for percutaneous coronary intervention (PCI) in patients with eGFR < 30 ml/min/1.73 m2 or history of contrast-induced nephropathy.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1607466/fullAKIcase reportchronic total occlusionlow-dose contrastmicrocatheter injectionnormal saline |
| spellingShingle | Arwin Saleh Mangkuanom Revan Satrio Brian Mendel Doni Firman Nanda Iryuza Amir Aziz Alkatiri Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case report Frontiers in Cardiovascular Medicine AKI case report chronic total occlusion low-dose contrast microcatheter injection normal saline |
| title | Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case report |
| title_full | Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case report |
| title_fullStr | Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case report |
| title_full_unstemmed | Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case report |
| title_short | Microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury: a case report |
| title_sort | microcatheter selective injection technique using ultra low contrast for percutaneous coronary intervention in patients with previous acute kidney injury a case report |
| topic | AKI case report chronic total occlusion low-dose contrast microcatheter injection normal saline |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1607466/full |
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