Zero-Contrast Percutaneous Coronary Intervention Guided by Dextran-Based Optical Coherence Tomography

Individuals with advanced chronic kidney disease (CKD) and coronary artery disease are often denied percutaneous coronary intervention (PCI) because of an aversion to the risk of contrast-induced nephropathy. We present the case of a 76-year-old man with stage 4 CKD requiring coronary revascularization. Zero-contrast PCI was successfully performed using dextran-based optical coherence tomography (OCT) guidance. Our report suggests the feasibility of dextran-based, OCT-guided, zero-contrast PCI in patients with advanced CKD. Further studies should evaluate the safety and efficacy of this novel approach.