Staged endovascular treatment of a patient after coronary artery bypass surgery with multifocal atherosclerosis and chronic kidney disease

• Karen V. Petrosian
• Aslanbek V. Karaev
• Alan B. Gurdzibeev
• Zalina F. Kudzoeva

Abstract

According to the results of modern studies, contrast-induced nephropathy is the third most important cause of acute renal failure, according to various data, it accounts for about 10% of all cases of acute renal failure. Risk factors for the development of contrast-induced nephropathy (CIN) can be associated with both the patient himself and the diagnostic or therapeutic procedure being performed. Reducing the volume of injected contrast agents reduces the risk of developing CIN and acute renal failure, respectively. This report demonstrates a clinical case of staged endovascular treatment of patient after coronary artery bypass grafting with multifocal atherosclerosis and chronic kidney disease, using innovative methods of intravascular diagnostics.

Keywords:internal thoracic artery bypass graft; ischemic heart disease; fractional flow reserve; instantaneous wave-free ratio

References

1. Tehrani S., Laing C., Yellon D.M., Hausenloy D.J. Contrast-induced acute kidney injury following PCI. Eur J Clin Invest. 2013; 43: 483–90. DOI: https://doi.org/10.1111/eci.12061

2. Dannenberg L., Polzin A., Bullens R., Kelm M., Zeus T. On the road: first-in-man bifurcation percutaneous coronary intervention with the use of a dynamic coronary road map and StentBoost Live imaging system. Int J Cardiol. 2016; 215: 7–8. DOI: https://doi.org/10.1016/j.ijcard.2016.03.133

3. Piayda K., Kleinebrecht L., Afzal S., Bullens R., ter Horst I., Polzin A, et al. Dynamic coronary roadmapping during percutaneous coronary intervention: a feasibility study. Eur J Med Res. 2018; 23: 36. Epub 2018 Jul. 31. DOI: https://doi.org/10.1186/s40001-018-0333-x

4. Toth G., Hamilos M., Pyxaras S., et al. Evolving concepts of angiogram: fractional flow reserve discordances in 4000 coronary stenoses. Eur Heart J. 2014; 35 (40): 2831–8.

5. Fearon W.F., Zimmermann F.M., De Bruyne B., et al. Fractional flow reserve-guided PCI as compared with coronary bypass surgery. N Engl J Med. 2022; 386 (2): 128–37. DOI: https://doi.org/10.1056/NEJMoa2112299

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)