1. Zero-Contrast Optical Coherence Tomography- and Physiology-Guided Percutaneous Coronary Intervention for Severely Calcified Lesion

    Zero-Contrast Optical Coherence Tomography- and Physiology-Guided Percutaneous Coronary Intervention for Severely Calcified Lesion

    An 80-year-old man with severe kidney dysfunction (estimated glomerular filtration rate, 26 mL/min/1.73 m 2 ) not requiring hemodialysis presented with effort angina. Diagnostic angiography with minimum contrast showed a diffuse lesion in the proximal right coronary artery (RCA; Figure A ). On a later day, optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) with dextran injection was performed. Because multiple cracks were seen in the severely calcified lesion after pre-dilation ( Figure B,C ; Supplementary Movie 1 ), an everolimus-eluting stent (3.25–33 mm) was implanted ( Figure D ). The final OCT showed sufficient luminal expansion (minimum stent area ...

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