Innovative Technique of Primary Percutaneous Coronary Intervention in Patients with Impaired Renal Function using Ultra Low Volume Contrast Agent Using Side Branch Wire as a Marker

Abstract

Contrast-induced nephropathy (CIN) is a serious complication in patients with chronic kidney disease with coronary artery disease who undergo percutaneous coronary intervention (PCI), and is associated with higher morbidity and mortality in short and long term. The limiting volume of contrast agent is safest and most reliable strategy to prevent CIN. Here, we report a case of suc¬cessful primary PCI using only 13 ml of contrast (iodixanol) of mid left anterior descending artery where wire in diagonal branch served as a landmark in a 75-year-old diabetic and hypertensive male who had presented with ST segment elevation anterior wall myocardial infarction and had marked renal dysfunction having serum creatinine of 3.3 mg%. There was no change in basal renal function after the procedure and safely discharged.