Novel approaches to percutaneous intervention in stage IV kidney disease

Abstract

Coronary artery disease (CAD) is common in patients with chronic kidney disease (CKD). We report the case of a 53-year-old diabetic male with stage IV CKD who presented to the emergency department with unstable angina. He underwent coronary angiography utilizing bilateral radial artery access and simultaneous injection of the right-and left-coronary systems during rotational coronary angiography to identify a high-grade mid-right coronary artery lesion. The lesion was treated using intravenous ultrasound to facilitate minimal-contrast percutaneous intervention and the patient avoided hemodialysis post-procedure. This case demonstrates a novel approach to coronary angiography and percutaneous intervention in patients with CKD.