80-year-old with kidney disease recovers after low contrast angioplasty

In a significant breakthrough for patients with Chronic Kidney Disease (CKD), Dr Sudhanshu Budakoty, Senior Consultant – Cardiology at Fortis Hospital, Mohali, on Tuesday announced the successful use of Ultra-Low Contrast Angioplasty guided by Intravascular Ultrasound (IVUS).

The advanced procedure was performed on an 80-year-old man living with CKD for more than five years, who arrived at the hospital with severe chest pain, breathlessness and elevated creatinine levels.

The patient was at extremely high risk for conventional angioplasty, which typically requires substantial amounts of contrast dye to visualise blood vessels.

Such dyes can further damage kidney function and, in severe cases, push CKD patients toward dialysis. To avert this risk, Dr Budakoty opted for the cutting-edge ultra-low contrast technique, which uses minimal dye and integrates IVUS imaging for precise diagnosis and intervention. The patient recovered well and was discharged within two days.

Explaining the approach, Dr Budakoty said, “This patient had significant coronary artery disease, but being a CKD patient, conventional angioplasty posed a high risk of worsening his kidney function. Using IVUS, we could clearly assess the vessel size, lesion characteristics, stent placement and expansion, all while minimising contrast use. This ensured an excellent outcome without compromising kidney health.”

He further noted that Fortis Mohali routinely employs advanced imaging technologies such as IVUS and Optical Coherence Tomography (OCT) in high-risk cardiac cases. “These technologies help us achieve superior outcomes by guiding us through complex cases, even in patients with severe comorbidities like CKD.”

IVUS uses sound waves to visualise blood vessels from within, allowing accurate assessment of blockages and optimal stent deployment, while OCT uses light waves to generate high-resolution images of coronary arteries.