Role of intravascular ultrasound imaging in minimally enhanced percutaneous coronary interventions in patients with acute coronary syndrome

Aim. To evaluate the role of intravascular ultrasound (IVUS) in performing percutaneous coronary interventions (PCI) with minimal contrast enhancement in patients with acute coronary syndrome (ACS).

Material and methods. The single-center retrospective study included 269 patients with nonST-segment elevation ACS (NSTE-ACS) who underwent coronary artery stenting. Patients were divided into three following groups: group 1 — angiography-guided PCI (n=100), group 2 — PCI with IVUS use (n=100), and group 3 — PCI with the combined use of IVUS and minimal contrast agent administration (n=69). The primary analysis included the assessment of contrast agent volume during PCI, the changes of creatinine level, glomerular filtration rate, and the incidence of acute kidney injury in patients with NSTE-ACS.

Results. The smallest contrast agent amount (73,3±5,1 ml) was administered to patients in group 3, where PCI was accompanied by the combined use of IVUS and minimal contrast agent administration (analysis of variance [ANOVA]; p<0,001, with Tukey's post-hoc test). There were no significant differences between the groups in the changes of creatinine clearance and glomerular filtration rate.

Conclusion. Quantitative parameters of average contrast agent administration during PCI in the angiographic and IVUS control groups were identified. Some renal function parameters in these groups were assessed. The effectiveness of the combined use of IVUS and minimal contrast agent administration in patients with NSTE-ACS was shown.

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