Absolute zero-contrast percutaneous coronary interventions: An intravascular ultrasound-guided case series and literature review

•CM side effects (renal function impairment and hypersensitivity reactions) are a treatment burden to vulnerable patients.•The complete omission of CM during PCI with the advent of IVUS may be the answer to CM-associated adverse effects.•Zero-contrast IVUS-guided strategy based on a predetermined protocol is a feasible approach even in complex coronary lesions.•A randomized multicenter control trial will examine the effectiveness of this technique and its clinical significance.