Case 103: PCI Manual - DK crush with 5 mL of contrast

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An elderly patient with chronic kidney disease presented with non-ST segment elevation acute myocardial infarction and was found to have severe distal left main, mid LAD, and ostial RCA lesions. A decision was made to perform PCI of the LAD and left main lesions using the least possible amount of contrast. IVUS-guided PCI of the LAD and the left main was successfully performed using the DK crush technique for the left main bifurcation using only 5 mL of contrast.
  1. Manos Brilakis
  2. PCI
  3. percutaneous coronary intervention
  4. dk crush
  5. ivus
  6. chronic kidney disease
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Комментарии
Автор

Bravo👏👏👏. Very nice case presentation and management. Good job for you.

ahmedsabbar
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Thanks for your educative presentation.

shangz
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great, fully agree with you regarding zero contrast PCI. Case perfectly managed here.

tom
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Would you explain how saline injection helped you confirm guide catheter engagement ?

doctorcardio
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with contrast volume of 2x current GFR, he would receive 70ml. According to Acute kidney injury calculator for patients after PCI his risk of CIN is 14% and Dialysis risk is 0.12%.

tom
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Great case. But the data on modern dye causing AKI is extremely weak. It’s essentially a myth and CTA data (w iso-osmolar dye) shows that. Could easily use 40mL of dye in this patient. Nonetheless, as always, great case! Got your latest book!

jwilson
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Sir, why do we have to rewire SB in step 7, why not just perform KBI directly?

jainjeetesh