• Title/Summary/Keyword: Angioplasty

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Determinants of Successful Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술의 성공율에 영향을 미치는 인자에 대한 고찰)

  • Choi, Kyo-Won;Kweon, Jun-Young;Kim, Young-Jin;Lee, Tae-Il;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Seup;Lee, Hyun-Woo;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.230-239
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    • 1994
  • In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients (89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug. 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A (95.7%), type B (89.5%). There was signfifcantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bend > $45^{\circ}$ and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors. Stenosis severity, thrombus, lesion location at a bend > $45^{\circ}$, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.

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Outcome of Patch Angioplasty for Left Main Coronary Ostial Stenosis (좌주관상동맥 개구부 협착에서의 혈관성형술의 결과)

  • Kang, Chang-Hyun;Na, Chan-Young;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Baek, Man-Jong;Oh, Sam-Se;Kim, Woong-Han;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.56-63
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    • 2004
  • Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

Dosimetry and Medical Internal Radiation Dose of Re-188-DTPA for Endovascular Balloon Brachytherapy Against Restenosis after Coronary Angioplasty (혈관성형술 후 재협착 방지 치료에 사용하기 위한 원통형 풍선 Re-188-DTPA의 선량 분포와 내부피폭 선량)

  • Lee, Jin;Lee, Dong-Soo;Shin, Seung-Ae;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.2
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    • pp.163-171
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    • 1999
  • Purpose: Liquid beta emitter filled in angioplasty balloon could be used to perform endovascular balloon brachytherapy to prevent coronary artery restenosis. We investigated the dosimetry for Re-188-DTPA liquid-filled balloon and medical internal radiation dosimetry in case of balloon leakage. Materials and Methods: We estimated radiation dose from an angioplasty balloon (20 mm length, 3 mm diameter cylinder) to the adjacent vessel wall using Monte Carlo EGS4 code. We obtained time-activity curves of kidneys in normal dog and calculated $T_{max},\;T_{1/2}$. Using MIRDOSE3 program, we estimated absorbed doses to the major organs (kidneys, bladder) and the whole body when we assumed that balloon leaked all the isotope contained. Results: The radiation dose was 17.5 Gy at the balloon surface when we applied 3,700 MBq/ml of Re-188 for 100 seconds, Fifty percent of the energy deposited within 1 mm from the balloon surface. The estimated internal dose to the whole body was 0.005 mGy/MBq and 18.5 mGy for the spillage of 3,700 MBq of Re-188. Conclusion: We suggest that Re-188-DTPA can be used for endovascular balloon brachytherapy to inhibit coronary artery restenosis after angioplasty with tolerable whole body radiation dose in case of balloon rupture.

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Usefulness of ultrasonography radial artery diameter with lumen evaluation (초음파를 이용한 요골동맥의 직경 및 내강 평가)

  • Park Young-Hee
    • Journal of The Korean Radiological Technologist Association
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    • v.27 no.2
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    • pp.175-180
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    • 2001
  • Ⅰ. Background and Objectives : Recently the percutaneous transradial approach for coronary angiography and angioplasty has been using. When the radial artery as a graft for coronary artery bypass surgery was used, pantency increased. Many examination and

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Transmyocardial Laser Revascularzation for Patients with Recurrent Angina after CABG -Report of 3 cases - (관상동맥 우회로술 후 재발한 협심증의 경심근 레이저 혈류 재건술 치험 3례)

  • Lee, Ho-Seok;Park, Kay-Hyun;Jun, Tae-Gook;Park, Pyo-Won;Chae, Hurn
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.576-580
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    • 2000
  • Transmycardial laser revascularization has made its position as a sole therapy for patients with chronic angina nonamenable to maximal medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting. We report three cases of transmyocardial laser revascularization as a sole therapy for patients with recurrent angina after CABG.

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Emergency Coronary Artery Bypass Following Unsuccessful Percutaneous Transluminal Coronary Angioplasty -A Case Report- (경피적 관상동맥성형술후 응급 관상동맥 우회로 조성술 경험)

  • 안욱수
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.373-378
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    • 1988
  • Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

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Initial Palliation of the Pulmonary Atresia with Interventricular Communication (심실간 중격결손을 동반한 폐동맥 폐쇄증의 일차 고식적 수술)

  • 김삼현
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.23-31
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    • 1992
  • The ideal approach in the staged management of patients with pulmonary atresia has been a challenging problem and the result has not been always satisfactory. We reviewed our early result of initial palliative surgeries in fifteen cases of pulmonary atresia with interventricular communication Included are eight cases of simple pulmonary atresia with ventricular septal defect and seven cases of pulmonary atresia associated with other complex cardiac anomalies. The ages of the patients were less than one year except one. The morphology of pulmonary vasculature was highly variable and showed unfavorable conditions in most cases. Pulmonary artery was nonconfluent in two. Two-thirds of all cases showed significant problems such as juxtaductal stenosis or diffuse hypoplasia. The ductus arteriosus usually narrowed at its pulmonic end. Initial palliation was done by modified Blalock-Taussig shunt in six, central shunt with or without pulmonary angioplasty in five, right ventricular outflow tract [RVOT] reconstruction in three and direct connection of nonconfluent pulmonary arteries with bilateral cav-opulmonary shunt in one patient. There were 3 hospital deaths. Two of them underwent simultaneous repair of the associated anomaly of TAPVR. Among the six patients who received modified Blalock-Taussig shunt, three needed early second palliative procedure by central shunt, RVOT patch reconstruction and pulmonary angioplasty in each case, All patients who received central shunt showed marked clinical improvement. Among the twelve patients who survived the palliative procedures, two patients underwent total correction 13 months and 18 months after initial palliation respectively. We think that the choice of palliative procedure must be individualized according to the morphology of the pulmonary arteries. More experience and long term follow-up data are necessary to meet this challenging problem.

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Factors Influencing Health Status in Patients with Acute Coronary Syndrome (급성관상동맥증후군 환자의 건강상태에 영향을 미치는 요인)

  • Nam, Hohee;Kang, Younhee
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.161-169
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    • 2017
  • Purpose: This study was done to investigate the correlation of illness perception, coping strategy and health status in patients with acute coronary syndrome who had undergone a coronary angioplasty. Methods: A descriptive correlational design was used in this study. A total of 102 patients with acute coronary syndrome was recruited. Data were collected using structured questionnaires including scales for the illness perception, the coping strategy, and health status. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis. Results: Health status showed significant correlations with illness perception (r=-.44, p<.001) and avoidance coping (r=-.33, p=.001); illness perception, avoidance coping explained 21% of variance in health status (F=8.58, p<.001). The factors that influenced health status were illness perception (${\beta}=-.37$, p<.001), and avoidance coping (${\beta}=-.21$, p<.001). Conclusion: The findings of this study indicate that illness perception and avoidance coping were significant variables for health status in patients with acute coronary syndrome who had undergone a coronary angioplasty.

Effects of Demethoxycurcumin Isolated from Radix Curcumae on Arterial Restenosis in Rats (울금(鬱金)에서 분리된 demethoxycurcumin이 백서의 혈관재협착에 미치는 효과)

  • Kil, In-Ho;Chong, Myong-Soo;Shin, Chang-Ho;Pae, Hyun-Ock;Chung, Hun-Taeg;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.3
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    • pp.67-80
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    • 2008
  • The pathobiologic process of arterial stenosis following balloon angioplasty continues to be an enigmatic problem in clinical settings. This study investigates the ability of demethoxycurcumin, a curcuminoid isolated from Radix Curcumae, to attenuate balloon injury-induced neointima(NI) formation in the rat carotid artery. It was found that demethoxycurcumin induced inducible heme oxygenase(HO-1) expression and inhibited dose-dependently cellular proliferation in rat vascular smooth muscle cells. Perivascular application of demethoxycurcumin immediately following injury significantly reduced NI area and NI thickness 2 weeks post-injury. Interestingly, treatment with tin-protoporphyrin IX, a HO inhibitor, reversed the effects of demethoxycurcumin on NI formation. These results implicate demethoxycurcumin as a potent new therapeutic agent that is capable of reducing post-angioplasty arterial stenosis through induction of the HO-1 expression.

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