Zero contrast optical coherence tomography–guided percutaneous coronary intervention for in-stent restenosis of the saphenous vein graft using a non-contrast flush medium

Abstract

Percutaneous coronary intervention (PCI) is often denied for individuals with coronary artery disease who are prone to develop contrast-induced acute kidney injury. We report a 73-year-old, stage 3 chronic kidney disease patient (CKD), who underwent coronary artery bypass surgery and saphenous vein graft (SVG) stenting in the past, presented with in-stent restenosis (ISR) of SVG stent. Zero contrast optical coherence tomography (OCT) guided–PCI was successfully performed using low molecular weight dextran-40 (LMWD-40) as the flush medium. Our report suggests the safety and feasibility of LMWD-40–based OCT-guided zero contrast PCI in ISR of SVG in a CKD patient, although further prospective studies are needed to evaluate this technique. Keywords: Zero contrast, Optical coherence tomography, Dextran-40, Chronic kidney disease, Percutaneous coronary intervention, Contrast induced-Acute kidney injury