Elective percutaneous coronary intervention performed during contrast-induced hypotension.

Armaghan Y Soomro,Nureddin Almaddah,Shiv Kumar Agarwal,Barry F Uretsky,Vasili Lendel

doi:10.1002/ccd.29958

Abstract

To demonstrate the feasibility and safety of performing elective percutaneous coronary intervention (PCI) during contrast reaction producing severe hypotension. The development of profound hypotension due to a contrast reaction requires emergency treatment and usually signals procedure termination. We report successful completion of planned PCI with blood pressure support with vasopressors during contrast-induced hypotension in nine procedures in three patients with previously known contrast reaction causing hypotension. This case series provides support for the feasibility and safety of performing successful planned PCI under blood pressure support in patients with contrast reaction causing severe hypotension. A management approach for considering intervention in the setting of contrast-induced hypotension is provided.

Highlights

We report successful completion of planned percutaneous coronary intervention (PCI) with blood pressure support with vasopressors during contrast-induced hypotension in 9 procedures in 3 patients with previously known contrast reaction
Severe hypotension is a rare complication of injecting iodinated contrast media during percutaneous coronary intervention (PCI)
Most of the current medical literature has concentrated on the pathophysiological mechanisms and treatment of this disorder, and very little has been written on the ability to continue an interventional procedure during the reaction or planning an elective procedure in the setting of known severe contrast reaction

Summary

Conclusions

This case series provides support for the feasibility and safety of performing successful planned PCI under blood pressure support in patients with contrast reaction causing severe hypotension. A management approach for considering intervention in the setting of contrast-induced hypotension is provided

Introduction

Discussion

Conclusion