Ultra-Low-Contrast PCI: A Structured Approach to Reducing Dependence on Contrast Vessel Opacification in PCI
Issued Date
2025-02-24
Resource Type
ISSN
19368798
eISSN
18767605
Scopus ID
2-s2.0-85217426939
Journal Title
JACC: Cardiovascular Interventions
Volume
18
Issue
4
Start Page
409
End Page
424
Rights Holder(s)
SCOPUS
Bibliographic Citation
JACC: Cardiovascular Interventions Vol.18 No.4 (2025) , 409-424
Suggested Citation
Shabbir A., Ali Z., Colletti G., Dudek D., Garbo R., Hellig F., Moses J., Mozid A., Nakamura S., Patel B., Toth G.G., Wongpraparut N., Gonzalo N., Escaned J. Ultra-Low-Contrast PCI: A Structured Approach to Reducing Dependence on Contrast Vessel Opacification in PCI. JACC: Cardiovascular Interventions Vol.18 No.4 (2025) , 409-424. 424. doi:10.1016/j.jcin.2024.11.043 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/105319
Title
Ultra-Low-Contrast PCI: A Structured Approach to Reducing Dependence on Contrast Vessel Opacification in PCI
Author's Affiliation
New Tokyo Hospital
Siriraj Hospital
GVM Care & Research S.p.A.
Clinique Saint-Joseph, Arlon
Maria Cecilia Hospital
Columbia University Irving Medical Center
Universidad Complutense de Madrid
Jagiellonian University Medical College
St. Francis Hospital - The Heart Center
Leeds General Infirmary
Medizinische Universität Graz
University of Cape Town
Gleneagles JPMC
Sunninghill Hospital
Siriraj Hospital
GVM Care & Research S.p.A.
Clinique Saint-Joseph, Arlon
Maria Cecilia Hospital
Columbia University Irving Medical Center
Universidad Complutense de Madrid
Jagiellonian University Medical College
St. Francis Hospital - The Heart Center
Leeds General Infirmary
Medizinische Universität Graz
University of Cape Town
Gleneagles JPMC
Sunninghill Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Since its inception, percutaneous coronary intervention (PCI) has relied upon vessel opacification with iodinated contrast to plan, guide, and assess the results of the procedure. Yet revisiting this fundamental concept is important in contemporary PCI practice, especially in patients with high-risk clinical or anatomical profiles. In addition to decreasing the probability of acute kidney injury during PCI, limiting the volume of iodinated contrast allows the operator to perform more thorough interventions by relying on intracoronary imaging and physiology, ultimately contributing to more complete revascularization and improving the efficacy and durability of the intervention. Ultra-low-contrast PCI (ULCPCI) may thus be useful in performing PCI not only in patients with chronic renal dysfunction but also in those with multivessel coronary artery disease, impaired left ventricular function, and many other scenarios. The aim of this review is to highlight contemporary PCI scenarios in which a ULCPCI approach may be beneficial. The authors provide a structured approach to address the challenges faced by operators in transitioning from conventional contrast-based interventions to ULCPCI, with practical solutions that are accessible to most interventionalists. The reader will learn that ULCPCI is feasible in contemporary practice as a result of technological innovation, the implementation of dedicated skills, and redefining the role of angiography as the cornerstone of contemporary PCI.