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Dynamic Coronary Roadmap Reduces Contrast Use in Percutaneous Coronary Interventions

19 Feb 2024
contrast and PCI

Minimizing iodinated contrast use stands as a critical safety measure in percutaneous coronary interventions (PCI), especially for patients at heightened risk of contrast-induced acute kidney injury (CI-AKI). Dynamic Coronary Roadmap (DCR) serves as a PCI navigation aid by projecting a motion-compensated virtual coronary roadmap overlay onto fluoroscopy, potentially diminishing the necessity for contrast during PCI. In the Dynamic Coronary Roadmap for Contrast Reduction (DCR4Contrast) trial investigators sought to assess the contrast-conserving capabilities of DCR in PCI when compared to conventional angiographic guidance.

The DCR4Contrast trial (NCT04085614) results were recently published in EuroIntervention and was a multinational, prospective, unblinded, stratified 1:1 randomized controlled trial. Patients were allocated randomly to either DCR-guided PCI or conventional angiography-guided PCI. The primary endpoint was the total volume of iodinated contrast administered, with the secondary endpoint being the number of cineangiography runs during PCI.

The study comprised 356 randomized patients (179 in the DCR group and 177 in the control group). No disparities in patient demographics, angiographic traits, or estimated glomerular filtration rate (eGFR) were observed between the groups. DCR guidance significantly reduced the total contrast volume used during PCI compared to conventional angiographic guidance (64.6±44.4 ml vs. 90.8±55.4 ml, respectively; p<0.001). Additionally, the DCR group exhibited a noteworthy reduction in the total number of cineangiography runs (8.7±4.7 vs. 11.7±7.6 in the control group; p<0.001).

The investigators concluded that DCR-guided PCI demonstrated a substantial reduction in both contrast volume and the number of cineangiography runs compared to conventional angiography-guided PCI.

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Original article: Hennessey B et al. EuroIntervention. 2024 Feb 5;20(3):e198-e206. 

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