Comparison of changes in creatinine clearance in patients undergoing optical coherence tomography versus intravascular ultrasound.

Introduction: The use of intravascular imaging during percutaneous coronary intervention (PCI) has been shown to have a significant positive impact on clinical outcomes. The two most frequently used techniques of intravascular imaging for guiding decision-making and optimizing PCI are intravascular ultrasound (IVUS) and optical coherence tomography (OCT).

Aim: To investigate the impact of iodinated contrast agent administration on creatinine clearance and renal function in patients undergoing OCT and IVUS procedures.

Material and methods: An observational retrospective study was conducted at a tertiary institution involving a total of 336 consecutive patients who underwent intracoronary imaging (OCT/IVUS) and PCI procedures with stent implantation. The study included patients in whom intracoronary imaging was used to guide the procedure as well as those in whom it was used to verify the results of stent implantation.

Results: A significant increase in creatinine (greater than 25% from the initial creatinine value) was recorded in 12 patients (3.6%), with 7 patients from the OCT group (4.7%) and 5 patients from the IVUS group (2.7%), p > 0.01. The difference in mean values regarding the imaging groups was statistically significant for the variable amount of contrast medium used (p < 0.01), where the median contrast volume in the OCT group was 320.0 ml and in the IVUS group it was 270.0 ml.

Conclusions: Through retrospective analysis, we can conclude that adequate patient selection for OCT guidance led to increased contrast consumption but did not result in worsening of renal function with adequate patient preparation and parenteral and oral hydration.