• Title/Summary/Keyword: 경피적 관상동맥중재술

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Hybrid Off-pump Coronary Artery Bypass Combined with Percutaneous Coronary Intervention: Indications and Early Results (심폐바이패스 없이 시행하는 관상동맥우회술과 경피적 관상동맥중재술의 병합요법 : 적응증 및 조기성적)

  • Hwang Ho Young;Kim Jin Hyun;Cho Kwang Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.733-738
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    • 2005
  • Background: The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. Material and Method: From January f998 to July 2004, 25 $(3.2\%)$ patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was peformed before CABG in 8 patients and after CABG in 47 patients. Result: The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial grafi available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was $2.3\pm1.0$. Mean number of lesions treated by PCI was $1.2\pm0.4$. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography $(1.8{pm}1.6days)$ revealed $100\%$ patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; $25{\pm}26$ months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed .all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents. Conclusion: In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.

Surgical Retrieval of Fractured Percutaneous Coronary Intervention Guidewire (경피적 관상동맥 중재술 시 골절된 가이드 와이어의 외과적 제거)

  • Lee Jun-Wan;Kim Sang-Pil
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.640-642
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    • 2006
  • Entrapment and fracture of coronary angioplasty hardware are rare complications of percutaneous coronary intervention (PCI). Retained guidewire should be removed either percutaneously or surgically, because it could serve as a nidus for thrombus formation. We report on a successful surgical retrieval of entrapped PCI guidewire and subsequent bypass grafting of the affected coronary vessel.

Surgical Removal of a IVUS Catheter that was Fractured During PCI (경피적 관상동맥 중재술 시 골절된 혈관 내 IVUS 카테터의 외과적 제거)

  • Kim, Young-Hak;Kim, Hyuck;Song, Young-Joo;Chung, Won-Sang;Kang, Jeong-Ho
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.768-771
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    • 2008
  • The use of IVUS provides information about the lumen and arterial wall, the location and extent of atherosclerotic plaque and the state of the arterial wall after PCi. The use of IVUS after insertion of an intracoronary stent has currently increased, while conflicting evidence exists concerning the long-term benefits of IVUS. We report here on a case of surgical removal of an entrapped and fractured IVUS catheter during insertion of intracoronary stents, and we include a review of the relevant literature.

Early-Onset Postcardiac Injury Syndrome after Percutaneous Coronary Intervention Recovered with Steroids (경피적 관상동맥중재술 후 급성으로 발생한 스테로이드 치료로 회복한 심근 손상 후 증후군)

  • Kim, Min-Jeong;Yoon, Seong-Bo;Lee, Myong Dong;Kim, Si-Ho;Kim, Young Woo
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.565-570
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    • 2018
  • Postcardiac injury syndrome (PCIS) is an inflammatory process that usually occurs within 1 to 6 weeks after an injury to the pericardium, epicardium, or myocardium. As more interventions are performed for complicated coronary artery obstructive lesions, there have been some recent reports on PCIS following percutaneous coronary intervention (PCI). The medical management of PCIS depends on nonsteroidal anti-inflammatory drugs (NSAIDs), in addition to colchicine or steroids. An 80-year-old male patient underwent a PCI. Unfortunately, the guidewire piercing failed but he showed no immediate signs of complication. However, 5 hours after the procedure, he complained of chest discomfort. An electrocardiogram showed widespread ST elevation. Chest X-ray and computed tomography showed pulmonary congestion with pleural effusion, while thoracic echocardiography showed a moderate amount of pericardial effusion. NSAIDs were initiated, but there was no improvement of symptoms. We describe an unusual case of atypical earl onset PCIS after PCI, recovered rapidly by steroids.

Development of Algorithm for Nursing Interventions after Percutaneous Coronary Intervention (경피적 관상동맥중재술 후 간호중재 알고리즘 개발)

  • Ji, Hye-rim;Kim, Dong-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.1
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    • pp.18-29
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    • 2017
  • Purpose: The purpose of this study was to develop an algorithm for nursing care after percutaneous coronary intervention in order to improve patients' safety and prevent complications, because percutaneous coronary intervention is becoming a common treatment for coronary artery diseases. Methods: By reviewing related literatures and interviewing nurses, items and paths that were to be used in the algorithm for nursing care after percutaneous coronary intervention were drawn up and a draft algorithm was developed. The final algorithm was determined based on the results of the evaluation performed after clinical application. Results: According to the outcome after allowing nurses to apply the revised algorithm with 11 patients, suitability on items composing the algorithm were highly rated whereas promptness was lowly rated. Although the patients (n=11) to whom the algorithm was applied complained of less back pain (p=.001) and discomfort (p=.026) compared to the patients (n=17) to whom the algorithm was not applied, no significant difference in bleeding complication was found. Conclusion: The findings in the study support the clinical utilization of the algorithm for nursing care after percutaneous coronary intervention as the use of this algorithm reduced back pain and discomfort without increasing bleeding complications at the femoral puncture site.

The Effect of Back Pain Prevention Intervention Program on Back Pain Relief in Patients Following Percutaneous Coronary Intervention (요통예방 중재 프로그램이 경피적 관상동맥 중재술 후 환자의 요통완화에 미치는 효과)

  • Lee, Hyea Kyung;Park, Yeon Suk
    • The Korean Journal of Rehabilitation Nursing
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    • v.16 no.2
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    • pp.100-111
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    • 2013
  • Purpose: The purpose of this study was to identify the effectiveness of back pain prevention intervention program on reducing back pain of patients undergoing percutaneous coronary intervention (PCI). Methods: The patients were divided into two groups as the experimental group and control group. In the experimental group, the participants took bedrest for 4 hours after PCI and then received back pain prevention intervention program (BPPIP). Total of 5 times BPPIP with 1 hour interval for 5-10 minutes per each intervention was administered to the patients taking bedrest for 4 hours after PCI. In the control group, total of 5 times routine nursing care with 1 hour interval was administered to the patients taking bedrest for 4 hours after PCI. The data were collected on admission in the ICU and after the 5 exercise sessions. The collected data were analyzed using SPSS/WIN program. Results: No significant differences in the occurrence of hemorrhage after the BPPIP were observed between the experimental group and the control group. After the BPPIP, back pain outcomes were significantly low in the experimental group. However, urination disorder and cortisol level did not show a statistically significant differences between two groups. Conclusion: It is clear that BPPIP is a useful nursing intervention for reducing back pain of patients undergoing PCI.

Factors Influencing Life Satisfaction of Elderly Patients after Percutaneous Coronary Intervention (경피적 관상동맥중재술을 받은 노인의 삶의 만족도 영향 요인)

  • Han, Mi-Na;Kim, Hwasoon;Lee, Young-Whee
    • Journal of Korean Critical Care Nursing
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    • v.9 no.2
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    • pp.24-35
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    • 2016
  • Purpose: This study investigated the degree of stress, depression, mindfulness and life satisfaction of elderly patients who had undergone percutaneous coronary intervention (PCI) and identified factors influencing life satisfaction. Methods: Participants were 106 patients over 60 years who had undergone PCI in a university hospital. Results: The mean scores for stress, depression, mindfulness, and life satisfaction were $9.10{\pm}2.53$, $7.77{\pm}3.32$, $88.57{\pm}8.47$, and $17.40{\pm}5.38$ respectively. There were statistically significant differences in life satisfaction by main source of income (F = 4.74, p = .004) and perceived health status as compared with peer (F = 4.80, p = .010). Depression (p < .001) explained 38 % of the total variance of life satisfaction, and the explanatory power increased to 42 % when mindfulness (p = .035) was added. There were significant correlations among stress, depression, mindfulness and life satisfaction of the patients. Conclusions: Depression and mindfulness were significant influencing factors on subjects' satisfaction in life. To enhance the life satisfaction of the elderly patients after PCI, it is necessary to reduce depression and to develop mindfulness-based interventions.

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A Study of Diagnostic Reference Levels for Coronary Angiography and Percutaneous Coronary Intervention in Gyeongsang Area (관상동맥 조영술 및 경피적 관상동맥 중재술에 대한 진단참고준위에 관한 연구; 경상도지역중심)

  • Si-Wang Lim;Jung-Su Kim;Pyong-Kon Cho
    • Journal of radiological science and technology
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    • v.46 no.2
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    • pp.123-129
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    • 2023
  • Interventional cardiology procedures can involve relatively high radiation doses compared to conventional radiography. During CAG, CAG + PCI and PCI the same area is exposed to radiation for a long period. In this study, radiation exposure data of 421 examinations in Gyeongsang area were collected, and the DRLs and ADs in actual medical practice for three types of interventional cardiology procedures in Korea were established. In CAG 286 case, 75th percentile DRLs and ADs of the total DAP were 55.89 Gy·cm2 and 37.47 Gy·cm2 , respectively. In CAG + PCI 92 case, those values were 222.84 Gy·cm2 and 117.51 Gy·cm2 respectively. In PCI 43 case, those values were 198.73 Gy·cm2 and 120.13 Gy·cm2 respectively. In this study, for the first time, the diagnostic reference level of interventional cardiology procedures in Gyeongsang area were established. Using the diagnostic reference level of interventional cardiology procedures derived from this study, it will help to identify and improve the level of exposure dose in the region and country.

Literature Review of Nursing Intervention Studies for Patients Undergoing Percutaneous Coronary Intervention (경피적 관상동맥 중재술 환자에게 적용된 간호중재 연구 고찰)

  • Baek, Kyoung Hwa;Son, Youn-Jung
    • Perspectives in Nursing Science
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    • v.12 no.2
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    • pp.82-93
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    • 2015
  • Purpose: This study aimed to provide a systematic review of the evidence from controlled trials regarding nursing intervention studies on patients undergoing percutaneous coronary intervention, a discussion of the methodological problems that limit current research, and suggestions regarding future directions for research. Methods: Using a predefined protocol, 27 electronic databases were searched, studies selected, relevant data extracted, and the methodological quality of the studies assessed. Results: Twenty-seven studies were found reporting complex, generally heterogeneous interventions. The studies reported positive results, including self-efficacy, knowledge, and self-care. There were 6 randomized controlled trials, 19 quasi-experimental studies, and 2 only research group studies. In addition to support components, the interventions included elements of teaching, counseling, and education. Nursing interventions are still in the developmental and testing phase. Conclusion: The review demonstrated that a great deal is known about nursing intervention, the impact on a range of outcomes, and methodology. Although some useful evidence was reported for all interventions, further research needs to be carried out.

Edge Extraction using Fuzzy Techniques in Coronary Artery Image (Fuzzy 기법을 이용한 관상동맥영상의 에지추출)

  • Kim, Seong-Hu;Lee, Ju-Won;Kim, Joo-Ho;Lee, Han-Wook;Jung, Won-Geun;Lee, Gun-Ki
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.16 no.3
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    • pp.585-590
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    • 2012
  • Coronary Intervention treatment has become the core that is the test of cardiac catheterization to conduct treatment with Coronary Arteriography. Operators must be careful in Coronary Intervention treatment because the stent is inserted into the point of narrowing of blood vessel. So, the operator must correctly recognize the path of blood vessel to deal with the problems which are damages and ruptures of blood vessel, and there would be some errors of finding the path of blood vessel by bad qualify of the image. Therefore in this paper, median filtering is conducted by preprocessing to evaluate the performance of the effect of noise of the image that affects quality of the image and Fuzzy Edge Extraction Techniques is tested by using Soble Edge Extraction Techniques to compare the performance with The Fuzzy Edge Extraction Techniques. In result, the performance, removing the noise and extracting the signal of Fuzzy Edge Extraction Techniques using median filtering, demonstrates the superiority.