# IVUS-Guided Pulmonary Artery Hemodynamic Sensor Implantation: A Novel Contrast-Sparing Strategy

## TL;DR

This case report introduces a new method using IVUS to implant a heart sensor without contrast, which is safer for patients with kidney issues.

## Contribution

A novel contrast-sparing IVUS-guided technique for CardioMEMS implantation is introduced.

## Key findings

- IVUS can be used to guide CardioMEMS placement without intravenous contrast.
- The technique is feasible but requires familiarity with IVUS imaging of the left pulmonary artery.
- IVUS reduces contrast use, benefiting patients at risk of kidney failure.

## Abstract

This case report describes a novel insertion technique of a hemodynamic sensor (CardioMEMS), avoiding the need for intravenous contrast in patients with baseline renal dysfunction.

Intravascular ultrasound (IVUS) was employed to both visualize and direct the placement of the CardioMEMS. IVUS, along with fluoroscopy, were used to identify the left pulmonary artery as well as guide and confirm sensor placement.

The use of IVUS requires the operator to be familiar with identifying the appropriate target of the left pulmonary artery on ultrasound imaging. In addition, the introduction of IVUS in complex anatomy or a heavily calcified vessel may increase the risk of complications, including vessel perforation, dissection, and thrombosis.

IVUS is a feasible technique for CardioMEMS placement, minimizing the need for contrast. This is of particular importance in patients with heart failure and renal dysfunction, placing them at high risk for progression to renal failure.