Intracoronary Ultrasound

ABC

Editorial

From Coronary Artery to Kidney: Redefining the Goals of Intracoronary Imaging–Optimized Percutaneous Coronary Intervention

José Mariani Junior et al. Stefano Garzon Dias Lemos Pedro Alves Lemos Neto

Contrast-associated nephropathy has long been treated as an acceptable trade-off in interventional cardiology — a complication acknowledged but rarely prioritized. For decades, the field has lived with the uncomfortable reality that a technically flawless cardiac procedure can leave a patient with measurably worse function in another organ – the kidney – sometimes permanently. In current days, when diabetes, hypertension, and chronic kidney disease (CKD) are reaching “pandemic” levels, that resignation is no longer defensible. The most direct modifiable determinant of this injury — contrast volume — is now addressable, and intravascular ultrasound (IVUS) sits at the center of that solution.

The case for IVUS in complex coronary intervention is well established. It redefines how we size stents, assess expansion, and identify underexpansion, malapposition, edge dissections, and residual plaque burden. But its value extends beyond the technicalities of lesion complexity: in the right hands and with deliberate intent, IVUS transforms the same procedure into a substantially more renal-sparing one. The tool that optimizes coronary angioplasty can simultaneously protect the kidney — provided we choose to use it that way.

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ABC

Research Letter

Out of Sight, Out of Heart?

Costantino Roberto Costantini et al. Costantino Ortiz Costantini Sérgio Gustavo Tarbine Marcos Antonio Denk … Vinicius Shibata Ferrari Rafael Michel de Macedo

In December 1987, with over 300 experimental coronary implants performed in dogs and cadavers, Palmaz and Schatz, accompanied by Dr. Eduardo Sousa (Dante Pazzanese Cardiology Institute), performed the first human stent implantation in São Paulo, with a prosthesis developed by Palmaz himself.

However, the initial results of the first multicenter study on the subject were less than encouraging, as the device showed high rates of subacute occlusion (18%), despite the Palmaz stent presenting numerous favorable aspects of biocompatibility, mechanics, and hemodynamics.

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From Coronary Artery to Kidney: Redefining the Goals of Intracoronary Imaging–Optimized Percutaneous Coronary Intervention

Out of Sight, Out of Heart?

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Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)