A team of doctors at Sahyadri Hospitals led by Consultant Cardiologist Dr Abhijit Palshikar performed a zero contrast angioplasty recently on a fifty-three-year-old patient who was diagnosed with single vessel disease LAD (left anterior descending coronary artery). Zero contrast angioplasty is a boon for renal patients where intravascular ultrasound technology is used instead of the normal contrast (dye). The contrast can potentially cause further harm to the already malfunctioning kidneys.
Explaining the case Consultant Cardiologist at Sahyadri Hospitals Dr Abhijit Palshikar said, "The fifty-three-year-old presented to us with acute chest pain, sweating. Angiography pointed to single vessel disease LAD (left anterior descending coronary artery), which required Angioplasty. But the challenge was that the patient was suffering from diabetic nephropathy and therefore at high risk of renal failure if angioplasty was done using the traditional method of contrast."
Dr Palshikar said, "The technique of zero contrast angioplasty is a boon for kidney patients or those at high risk like diabetes with borderline creatinine. Instead of using the contrast used in conventional angioplasty, a small wire is inserted in the vessel; this is called intravascular ultrasound technology which helps visualize arteries from the inside."
"We conducted the angioplasty with this technique and a stent boost. The patient got back to routine in a few days. (Iodinated contrast media are frequently prescribed medications worldwide for both diagnostic and therapeutic procedures including peripheral angioplasty procedures and coronary interventions. Iodine-based contrast materials injected into a vein are used to enhance x-ray images and CT images. However, sometimes the dye can cause serious problems in the kidneys known as contrast-induced nephropathy. These special dyes can be a risk factor for changes in kidney function)," he added.
This kind of technique can be used in patients with borderline kidney disease or those who have undergone a kidney transplant. Such patients may find it challenging to have access to cardiovascular interventions as there is a high risk to kidneys.
Dr Palshikar said, "This technique is used where the cardiovascular intervention is relatively simple or of medium risk. Contrast angioplasty is preferred in cases where multiple stenting is required, or where there is a full blockage. The other factor is that the cost of intravascular ultrasound technology equipment is a concern. But as more and more doctors use this technique, the confidence in this technique will build up and be of use to renal patients."
