Successful non contrast percutaneous coronary intervention for patient with unstable angina and prior anaphylactic reaction to iodinated contrast medium.

A 53-year-old man, who had a history of angina treated by percutaneous coronary intervention without allergic reaction to contrast and coronary bypass surgery, was hospitalized due to epigastralgia and tarry stool. During an enhanced computed tomography for the evaluation of abdominal diseases, he became hypotensive and had chest pain. To diagnose acute coronary syndrome, coronary angiography (CAG) was performed after the intravenous administration of hydrocortisone. He became hypotensive again during the CAG, which revealed significant coronary artery stenosis in the right coronary artery. Despite the intensive medical treatment, he had angina even while walking in the ward. By using an intravascular ultrasound for coronary stent implantation and the second wire as a marker for the stent implantation, we performed coronary interventional procedures successfully for this patient without the use of iodinated contrast media.