# 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.

## Key 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.