• Title/Summary/Keyword: 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.

Comparison of Health Behaviors and Health Indices According to Percutaneous Coronary Intervention in Patients with Chest Pain -Analysis of Nursing Information Chart and Electronic Medical Record- (흉통환자의 관상동맥중재술 시행 여부에 따른 건강행위 및 건강지표 비교 - 간호정보조사지와 전자의무기록 분석-)

  • Kweon, Mi-Soo;Lee, Sook-Jeong
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.279-288
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    • 2019
  • The purpose of this study was to compare the health behaviors and health indices according to whether a percutaneous coronary intervention(PCI) was performed due to chest pain. This is a secondary data analysis study of nursing information questionnaires and electronic medical records of 247 chest pain patients in a hospital from January 2010 to December 2017. The participants were divided into non-PCI and PCI groups, and the health behaviors, blood pressure, and blood lipid levels were collected at the first hospital admission and re-admission. Collected data were analyzed using SPSS 24.0. As a result of the study, smoking and lipid levels were significantly healthier than the participants in PCI group during re-hospitalization. Non-PCI group had a high risk of smoking despite the high risk of coronary artery stenosis. It was found that continuous integrated management to promote health behavior is needed. The significance of this study was to identify the importance of health behavior in patients with the risk of cardiovascular disease.

Long-term Survival after Coronary Artery bypass Surgery (관상동맥 우회술의 장기 생존율)

  • Lee Mi Kyung;Jeong Eun Taik;Choi Jong Bum
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.139-145
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    • 2005
  • Background: There were very few reports on long-term survival after coronary artery bypass graft (CABG) in this country. The aim of this study is to investigate the long-term result in patients undergoing CABG in the early period in this hospital. Material and Method: One-hundred and fourteen patients (male/female, 79/35) who had undergone CABG from December 1990 to December 1995 were identified. Most of the patients had undergone CABG using left internal thoracic artery and vein grafts under cardiopulmonary bypass and cardiopulmonary arrest, and the proximal and distal anastomoses of the grafts were performed during the single aortic cross clamping period. Result: During the mean follow-up period of $135.5\pm17.9$ months, 37 patients $(32.5\%)$ were dead and only 10 patients $(27\%)$ of them died of cardiac cause. Risk-unadjusted survival after CABG was $95.6\%,\;85.1\%,\;71.8\%,$ and $57.9\%$ at 1, 5, 10, and 13 years, respectively, and cardiac death-free survival was $97.4\%,\;94.5\%,\;92.1\%$, and $81.3\%$ at 1, 5, 10, and 13 years, respectively. Predictable factors of long-term survival were sex and age. Predictable factors of postoperative coronary angiography and intervention were hypertension, diabetes, and dyslipidemia. Conclusion: Long-term survival after CABG in the early operative period was comparable to the previous outcomes, and females showed the better long-term survival. Postoperative coronary intervention was more common in patients with preoperative dyslipidemia.

Influencing Factors on Health Behavior Compliance in Men Who Underwent Percutaneous Coronary Intervention: Focusing on the Elapsed Period (관상동맥중재술을 받은 남성의 건강행위 이행에 미치는 영향요인: 경과기간을 중심으로)

  • Ha, Haeng-Ju;Seo, Minjeong
    • Journal of Digital Convergence
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    • v.19 no.12
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    • pp.661-673
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    • 2021
  • This study is a descriptive study to understand the effect on the health behavior compliance of men who got coronary intervention, focusing on the elapsed period. The subjects of this study were 249 men who underwent coronary intervention at a university hospital, and the collected data were analyzed using Stepwise multiple regression. As a result of the study, the influencing factors the implementation of healthy behaviors were self-regulation(β=0.35, p<.001), risk factors among educational request(β=-0.26, p<.001), and the elapsed period(β=0.19, p<.001), marital status(β=0.15, p=.001), educational level(β=-0.12, p=.035), and the total explanatory power was 29.1%. IIn order to increase the health behavior performance of male patients who underwent coronary intervention, it is necessary to develop a program that can strengthen the autonomous motivation of subjects with high severity and elapsed time of less than 1 year and more than 1 year.

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.

Effects of Single Vessel PCI (Percutaneous Coronary Intervention) using DCR (Dynamic Coronary Road map) on Fluoroscopy Time and Patient Radiation (동적 심혈관 로드맵을 이용한 중재적 시술이 투시 시간 및 환자 피폭에 미치는 영향)

  • Jong-Gil Kwak;Young-Hyun Seo
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.551-556
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    • 2023
  • Angiography equipment is used to evaluate and treat coronary artery disease. As a common feature of equipment, radiation is used, and function development for dose reduction is being carried out by each company. Therefore, the difference depending on whether DCR installed in angiography equipment is used is analyzed from a radiological point of view to prove the effect. Among 431 patients who underwent coronary artery intervention from March 2021 to February 2023, 250 patients with retrospective data were selected. And than among the 250 subjects obtained, 91 patients used the cardiovascular roadmap function during single-vessel intervention, and 159 patients did not use the roadmap. When DCR was used, total dose area product (34.57 uGy/m2 : 69.15 uGy/m2), total air kerma dose (688.47 mGy : 1640.4 mGy), fluoroscopy dose (23.87 uGy/m2 : 49.91 uGy/m2) and fluoroscopy time (723.55 s : 366.03 s), total number of images (17 : 26) showed lower values and were statistically significant than those not used. The use of DCR function in single vessel coronary intervention is thought to be radiologically safer as single vessel coronary intervention using dynamic cardiovascular DCR showed lower perspective time and perspective dose than procedures performed without the DCR.

Clinical Outcomes and Prognosis of Patients with Stent Fracture after Successful Drug-Eluting Stent Implantation (관상동맥 약물 방출 스텐트 삽입 후 스텐트 골절에 대한 임상결과 및 예후)

  • Kim, In-Soo;Han, Jae-Bok;Jang, Seong-Joo
    • Journal of radiological science and technology
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    • v.37 no.2
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    • pp.109-116
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    • 2014
  • Many studies have suggested that in the era of Drug-Eluting Stents(DES) are one of the causes of In-Stent Restenosis(ISR) of Stent Fracture(SF). The present study sought to evaluate clinical characteristics of patients with stent fracture after successful DES implantation. The 4,701 patients were selected for analysis who underwent a follow-up coronary angiography irrespective of ischemic symptoms. The overall incidence of SF was 32 patients(male:female=19:13, Av. age $62.44{\pm}9.8$year, 0.68%). Fractures of Sirolimus-Eluting Stents(SES), Paclitaxel-Eluting Stents(PES), Biolimus A9-Eluting Stents(BES), Everolimus-Eluting Etents(EES), Endothelial Progenitor Cell Capture Stent(EPC) and Zotarolimus-Eluting Stents(ZES) are accounted for 19(59.4%), 9(28.1%), 2(6.3%), 1(3.1%), 1(3.1%) and 0(0%) respectively. SF developed in the left Anterior Dscending(LAD) artery in 16 patients(50%) and in complex(type B2, C) lesions in 25 patients(69.4%). Ten patients were treated with heterogenous DES, the rest being treated with either homogenous DES(3 patients), plain old balloon angioplasty(3 patients), or conservative medical treatment(17 patients). None of the patients with SF suffered from cardiac death during a follow-up period of $32.9{\pm}12.4$ months. The overall rate of DES fracture over up to 3.7 years of follow-up was 0.68% with higher incidence in SES than in PES. SF frequently occurred in the LAD artery and in complex lesions. Of the patients with SF, coronary intervention was performed only when the binary restenosis lesion was significant. During the follow-up, patients with SF have continued on combination antiplatelet therapy. There is a very low rate of major adverse cardiac events(post-detection of SF), especially cardiac death associated with SF.