One case of contrast-free coronary intervention based on the integrated computed tomography angiography-intravascular ultrasound-fractional flow reserve strategy
10.3969/j.issn.1004-8812.2025.08.009
- VernacularTitle:基于CT血管造影-血管内超声-血流储备分数整合策略的无对比剂经皮冠状动脉介入治疗1例
- Author:
Xiao-shuang WU
1
;
Qin-ping ZHANG
;
Wei WANG
;
Yi LI
;
Lei GAO
Author Information
1. 中国人民解放军总医院第六医学中心心血管病医学部,北京 100048;安徽医科大学第二附属医院心内科,安徽 合肥 230601
- Publication Type:Journal Article
- Keywords:
Coronary CT angiography;
Intravascular ultrasound;
Fractional flow reserve;
Contrast-free;
Percutaneous coronary intervention
- From:
Chinese Journal of Interventional Cardiology
2025;33(8):477-480
- CountryChina
- Language:Chinese
-
Abstract:
Contrast-free percutaneous coronary intervention demonstrates significant value in reducing contrast-associated risks.This article reports a case of a patient with iodine contrast allergy and complex coronary artery disease(involving the left main stem,left anterior descending artery,and diagonal branch),who successfully underwent contrast-free percutaneous coronary intervention(PCI)through the integration of CT angiography(CCTA),intravascular ultrasound(IVUS),and fractional flow reserve(FFR)technology.Preoperative CCTA delineated the anatomy and planned the procedural approach.Intraoperatively,IVUS assessed plaque burden and vascular remodeling,precisely guiding stent selection and positioning.FFR was combined to evaluate the functional significance of the left main stem lesion and the ischemic significance of the specific stenosis in the left anterior descending artery.Post-procedural assessment evaluated stent result and the degree of flow limitation in the diagonal branch.Through"structure-function"dual optimization,revascularization of the left anterior descending artery was achieved using a single-stent strategy,avoiding intervention on the left main stem.This case confirms that multi-modality imaging techniques can safely manage complex lesions,significantly reduce contrast volume,and are suitable for high-risk patients with allergies or renal insufficiency.Future efforts should focus on standardizing technical protocols and accumulating evidence-based evidence to facilitate the clinical implementation of contrast-free interventions.
