Application of Noncontrast CT-Derived Volume Rendering Imaging and IVUS in Zero-Contrast EVAR: A Novel Technique

The combination of VR imaging and IVUS offers a viable alternative for zero-contrast EVAR, particularly in patients contraindicated for contrast agents. This renal-sparing technique expands EVAR options for high-risk populations.Clinical ImpactThis case presents a novel approach to zero-contrast endovascular aneurysm repair (EVAR) by combining non-contrast CT-derived volume rendering (VR) imaging and intravascular ultrasound (IVUS). This technique provides a renal-sparing solution for patients with chronic kidney disease (CKD) at high risk of contrast-induced nephropathy (CIN). By enabling accurate vascular mapping and device placement without contrast agents, procedural safety is enhanced. The innovation lies in integrating VR for visualization and IVUS for real-time intraluminal assessment, ensuring precision while avoiding contrast-related risks. This method may expand EVAR options and improve outcomes in CKD patients unsuitable for traditional contrast-based imaging.