• Title/Summary/Keyword: 경피적 관상동맥 중재술

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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.

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.

The Effects of Hand Massage in Patients Who Underwent Transradial Percutaneous Coronary Intervention (요골동맥을 통한 경피적 관상동맥 중재술 환자의 손마사지 효과)

  • Shin, Eun Sil;Kim, Myung-Hee
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.465-474
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    • 2018
  • Purpose: This study aimed to determine the effect of hand massage in patients who underwent transradial percutaneous coronary intervention. Methods: This was a quasi-experimental study with a nonequivalent control group and non-synchronized design. The study included 30 patients in the experimental group and 30 in the control group. Hand massage was performed 2 times for 5 minutes each in the experimental group and the control group only received usual nursing interventions. Pain, level of discomfort, and vital signs were defined as key outcome measures, and the data were analyzed using the chi-square test, an independent t-test, Mann-Whitney U test, repeated-measures analysis of variance, and Friedman test. Results: Significant differences were observed between the 2 groups in the pain score (F=7.91, p=.003), discomfort score (F=18.15, p<.001), pulse (F=12.92, p<.001), and respiration rate (${\times}^2=19.35$, p<.001). Conclusion: Hand massage can be a helpful nursing intervention for transradial percutaneous coronary intervention by reducing pain and discomfort to a considerable degree.

Comparison of Pain, Sense, Bleeding and Hematoma Depending on the Process of Air Elimination of Pressure Band after Percutaneous Coronary Intervention through Radial Artery (요골동맥을 통한 경피적 관상동맥 중재술 후 압박밴드의 공기제거 방법에 따른 통증 강도, 통증 감각, 출혈 및 혈종 비교)

  • Kim, Mi Seok;Oh, Ji Seon;Cho, Hye Young
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.275-283
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    • 2012
  • Purpose: This study was conducted to compare pain, sense, bleeding, and hematoma that patients feel depending on the process of eliminating air of pressure band that was applied to patients after percutaneous coronary intervention (PCI) through radial artery. Methods: It was a nonequivalent control group pretestposttest design to compare pain, sense, bleeding, and hematoma by amount and time of eliminating air of pressure band after PCI through radial artery. Results: On arrival at Coronary Care Unit, meaningful difference didn't exist between pain and sense, however, after two hours of starting eliminating air, the points of pain and sense were meaningfully low (p<.001). Also, there was meaningful difference in reciprocal action between group and time (p<.001). Conclusion: After PCI, the conclusion showed there is positive effect in decreasing wrist pain and sense without any influence of bleeding by eliminating air from patients' pressure bands.

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.

Effects of Smoking Cessation Education for Patients with Percutaneous Coronary Intervention (경피적 관상동맥 중재술을 받은 환자의 금연교육이 흡연에 미치는 효과)

  • Jun, Won-Hee;Yun, Hyun-Suk
    • Korean Journal of Adult Nursing
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    • v.24 no.3
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    • pp.274-283
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    • 2012
  • Purpose: The purpose of this study was to investigate the effects of a smoking cessation education for patients with percutaneous coronary intervention. Methods: The study was a quasi-experimental study with a non-equivalent control group non-synchronized design. The Sixty subjects were assigned to either the treatment group. The treatment intervention was a onetime program during hospitalization. Data were collected during several time periods: before treatment, immediately after treatment, two weeks later, and one month after the treatment. Data were analyzed with the SPSS 14.0 program with an independent t-test, $x^2$ test, repeated measures ANOVA. Results: There were significant differences between the two groups in terms of knowledge and attitude. The significance was absent for the testing two weeks post group intervention and then one month later the significance was again detected in the amount of smoking and smoking behavior. Conclusion: The results of this study suggest that smoking cessation education could be utilized for inpatients with percutaneous coronary intervention as nursing intervention in hospitals effectively. Further research is recommended in order to understand the change in significance in the different time periods.

The Effects of Heat Therapy on Low Back Pain, Blood Pressure and Pulse Rate after Percutaneous Coronary Intervention (경피적 관상동맥 중재술 후 온요법이 요통, 혈압 및 맥박에 미치는 효과)

  • Yun, So-Young;Cho, Bok-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.3
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    • pp.348-355
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    • 2011
  • Purpose: This study was done to examine the effects of heat therapy on low back pain, blood pressure and pulse rate after percutaneous coronary intervention. Method: The participants in this study were 40 patients who were admitted after having percutaneous coronary intervention. The experimental group, 20 patients, had heat therapy and the control group, 20 patients, maintained a supine position for 12 hours after the intervention. Back pain (VAS), blood pressure and pulse rate were measured just after removal of the sheath, and at 2-hour intervals up to 6 hours. Data were analyzed using SPSS 15.0. Results: The experimental group had significantly lower VAS for low back pain (F=23.44, p=.001). However no significant differences were found between two groups for blood pressure and pulse rate. Conclusion: The findings indicate that heat therapy is effective in reducing low back pain in patients who have had percutaneous coronary intervention. Therefore, heat therapy could be used as nursing intervention percutaneous coronary intervention.