AKI After PCI: Optimizing Contrast Selection for Real‑World Prevention-Preventing AKI Before and During PCI/PVI, Dr. Seto

Preventing AKI Before and During PCI/PVI, Dr. Seto

Video Transcription

Video Summary

The speaker discusses preventing contrast-associated acute kidney injury during cath procedures, especially in high-risk VA patients. AKI occurs 24–48 hours after contrast and raises risks of death, MI, and bleeding. Key prevention steps include identifying risk factors, giving pre-procedure hydration, limiting contrast volume, holding nephrotoxic drugs, and using high-dose statins in statin-naive patients. Bicarbonate and N-acetylcysteine do not help. During procedures, strategies include radial access, ultrasound-guided femoral access, lower-profile catheters, contrast dilution, guide extensions, roadmap imaging, and minimizing unnecessary injections. A case example shows successful PCI using only 23 mL of contrast.

Asset Caption

closed captions are computer-generated

Keywords

contrast-associated acute kidney injury

contrast-induced nephropathy

hydration prophylaxis

contrast volume minimization

percutaneous coronary intervention