Zero Contrast Percutaneous Coronary Intervention – A novel approach to reduce Contrast Induced Acute Kidney Injury

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Prathap Kumar Blessvin Jino Manu Rajendran


Iodinated contrast media are required in all cases who undergo coronary angiography and percutaneous coronary interventions (PCI). Though the modern contrast media (both low-osmolar and iso-osmolar) have lesser adverse effects than the older generation contrast media, they may lead to life threatening complications in few cases. Contrast induced acute kidney injury (CI-AKI) is one such complication where the presentation may vary from asymptomatic mild elevation in serum creatinine to life threatening uremia. Various pre-procedural and procedural steps are followed commonly to prevent CI-AKI and reducing the contrast volume is one of the most important steps. Indeed, multiple studies have proven that reducing the contrast volume during PCI reduces the risk of CI-AKI. More recently, intra-coronary imaging guided zero-contrast PCI has emerged as an important method to prevent CI-AKI. Though randomised controlled trials comparing low-contrast PCI and zero-contrast PCI are lacking, this technique is being used widely by experienced operators. Technical expertise in complex PCI and meticulous analysis of intra-coronary imaging, particularly intravascular ultrasound (IVUS), are mandatory for this procedure.

Keywords: Kidney Injury, Acute Kidney Injury, Reduce Contrast Induced Acute Kidney Injury, Zero Contrast Percutaneous Coronary Intervention, Coronary Intervention

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KUMAR, Prathap; JINO, Blessvin; RAJENDRAN, Manu. Zero Contrast Percutaneous Coronary Intervention – A novel approach to reduce Contrast Induced Acute Kidney Injury. Medical Research Archives, [S.l.], v. 10, n. 12, dec. 2022. ISSN 2375-1924. Available at: <>. Date accessed: 19 june 2024. doi:
Research Articles


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