Acute Kidney Injury After Percutaneous Coronary Intervention Guided by Intravascular Ultrasound

TL;DR

Using intravascular ultrasound during heart procedures may reduce kidney damage caused by contrast dye.

Contribution

This study shows that intravascular ultrasound guidance during PCI lowers acute kidney injury risk compared to angiography alone.

Findings

IVUS-guided PCI used significantly less contrast dye than angiography-guided PCI.

The IVUS group had 0% acute kidney injury, versus 12.12% in the angiography group.

IVUS guidance is safe and beneficial for patients at high risk of kidney injury.

Abstract

Purpose

We investigated the impact of intravascular ultrasound guidance on reducing the incidence of contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention (PCI).

Methods

Ninety-nine patients were enrolled in this prospective cohort who were not randomly assigned to angiography-guided percutaneous coronary intervention or intravascular ultrasound-guided percutaneous coronary intervention. The patients were hospitalized at the Vietnam National Heart Institute - Bach Mai Hospital between 2019 and 2020. Acute kidney injury incidence during hospitalization was the primary endpoint.

Results

A total of 99 patients were divided into two groups: the intravascular ultrasound-guided group (33 participants) and the angiography-guided group (66 participants). The mean ± SD contrast volume of each group was 95.2 ± 37.1 mL and 133.0 ± 36.0 mL for the ultrasound-guided and angiography-guided groups, with P < 0.0001. Intravascular imaging-guided percutaneous coronary intervention (IVUS-guided PCI) was associated with reduced acute kidney injury incidence during hospitalization: 0.0% vs. 12.12% and P = 0.049.

Conclusions

Intravascular ultrasound is a safe imaging tool that guides percutaneous coronary intervention and significantly reduces the rate of acute kidney injury compared to angiography alone. Patients who have a high chance of experiencing acute kidney injury benefit from using intravascular ultrasound.

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