Dr. N. Prathap Kumar Successfully Performs Zero Contrast Angioplasty in Chronic Kidney Disease Patients

Intravascular administration of iodinated contrast media is common but for patients that suffer from acute kidney deficits, contrast dye is associated with numerous adverse outcomes. Dr. N. Prathap Kumar who is internationally acclaimed for performing most complex angioplasties has been working on ‘zero contrast’ technique and has demonstrated 100% success rate in over 40 such angioplasties.

Dr. N. Prathap Kumar says, “Though the incidence of Contrast-Induced Nephropathy in patients with normal renal function is low, it increases significantly among patients with chronic kidney disease and diabetes. The zero contrast technique adopted by us has shown promising results. We have performed this technique multiple times in the last few months in our hospitals and not even a single patient had to face chances of permanent dialysis.”

Angiography is performed in heart patients to identify the blockage in the heart and to understand the anatomy of the blood vessels of the heart. This helps the doctors to choose between balloon angioplasty or bypass surgery as the treatment solution. Prior to Angiography, normally patients are administered iodine contrast liquid from 25 ml to 100 ml depending on the case requirement, which may be risky sometimes for patients who already have underlying kidney problems.

When the contrast is restricted to a bare minimum amount, the kidneys’ chances of getting impacted are greatly reduced. This is especially true in a patient with high creatinine level and old age patients with low haemoglobin level. When angiogram is done in patients with the above-mentioned conditions, with high contrast or a large amount of dye that gets into the body for the procedure, patients may go into kidney failure, pushing them into a condition of permanent dialysis. This complication happens in at least 5-20% of such cases.

“We have data of patients who have undergone the Zero Contrast angiography in most complex cases including patients with calcium, in tortuous anatomy and instances of 100 blocked vessel and all cases are doing fine. With the help IVUS imaging, multiple stents have also been planted in patients,” adds Dr. N. Prathap Kumar.

Depending on the kidney function, one can categorise the kidney patient into three spectrums – patient with normal kidney function, patient with abnormal kidney function but has not undergone dialysis, patient with abnormal kidney function and is on dialysis. In the 1^st & 3^rd category, there is not much concern about contrast amount as their chances of getting further into dialysis are less than 0.3 percent. But in the 2^nd category of patients with impaired kidney function who are undergoing angioplasty, the chances of permanent dialysis increases significantly.

To conclude Dr. Kumar says “It is technically very promising approach for the prevention of contrast-induced nephropathy (CIN). Zero contrast is creating a new era in the field of coronary intervention especially treating those patients with chronic issues including diabetes, heart failure, acute coronary syndrome and cardiogenic shock, for such patients zero contrast technique is a boon and brings in new hope.”

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