CASE REPORT article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1607466
This article is part of the Research TopicCase Reports in Coronary Artery Disease: 2025View all 7 articles
Microcatheter Injection Technique Using Normal Saline for Percutaneous Coronary Intervention in Patients with Previous Acute Kidney Injury: a Case Report
Provisionally accepted
- National Cardiovascular Center Harapan Kita (Indonesia), Jakarta, Indonesia
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Background: Contrast-induced nephropathy (CIN) is a risk in angiographic procedures, especially for patients with acute kidney injury (AKI). To mitigate this risk, ultra-low contrast percutaneous coronary intervention (ULC-PCI) has been developed, which minimizes the use of contrast agents.A 54-year-old woman with a history of AKI from a prior percutaneous coronary intervention (PCI) was found to have coronary artery disease with three vessels disease and chronic total occlusion in the right coronary artery. To minimize contrast use, she underwent ultra-low contrast PCI using the "microcatheter injection" technique, with only 5 cc of contrast used during the procedure. At one-year follow-up, the patient's LVEF improved from 33% to 56%, symptoms resolved with no chest pain. Her estimated glomerular filtration rate (eGFR) showed no significant decrease, since serum creatinine increased slightly from 1.59 mg/dL to 1.61 mg/dL. and eGFR decreased from 39 to 38 mL/min/1.73 m² in 72 hours.The microcatheter injection technique may serve as a viable strategy for percutaneous coronary intervention (PCI) in patients with eGFR<30 mL/min/1.73 m² or history of contrast-induced nephropathy.
Keywords: AKI, case report, chronic total occlusion, low-dose contrast, microcatheter injection, Normal saline, Percutaneous Coronary Intervention
Received: 07 Apr 2025; Accepted: 23 Jun 2025.
Copyright: © 2025 Mangkuanom, Satrio, Mendel, Firman, Iryuza and Alkatiri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Brian Mendel, National Cardiovascular Center Harapan Kita (Indonesia), Jakarta, Indonesia
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