RESUMO
Purpose We investigated the impact of intravascular ultrasound guidance on reducing the incidence of contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention (PCI). Methods Ninety-nine patients were enrolled in this prospective cohort who were not randomly assigned to angiography-guided percutaneous coronary intervention or intravascular ultrasound-guided percutaneous coronary intervention. The patients were hospitalized at the Vietnam National Heart Institute - Bach Mai Hospital between 2019 and 2020. Acute kidney injury incidence during hospitalization was the primary endpoint. Results A total of 99 patients were divided into two groups: the intravascular ultrasound-guided group (33 participants) and the angiography-guided group (66 participants). The mean ± SD contrast volume of each group was 95.2 ± 37.1 mL and 133.0 ± 36.0 mL for the ultrasound-guided and angiography-guided groups, with P < 0.0001. Intravascular imaging-guided percutaneous coronary intervention (IVUS-guided PCI) was associated with reduced acute kidney injury incidence during hospitalization: 0.0% vs. 12.12% and P = 0.049. Conclusions Intravascular ultrasound is a safe imaging tool that guides percutaneous coronary intervention and significantly reduces the rate of acute kidney injury compared to angiography alone. Patients who have a high chance of experiencing acute kidney injury benefit from using intravascular ultrasound.
RESUMO
The symptoms of acute renal infarction (ARI) caused by atheroemboli are vague, making it rare. Early diagnosis of renal infarction can be made through contrast-enhanced CT of the abdomen. However, diagnosing atheroemboli is more challenging. Kidney biopsy is the most accurate method to determine the cause, but it may not always be available in clinical settings. In cases where a thrombectomy is performed, white substances in thrombus aspiration or the patient's blood can suggest a diagnosis. Intervention is an effective technique, but there is controversy due to a lack of data, particularly in lobular artery infarction. We successfully treated one case using thrombus aspiration, and the specimens suggested atherosclerosis as the cause.
