• Korean Circulation Journal
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• v.48 no.12
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• pp.1120-1130
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• 2018

Background and Objectives: Feasibility of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via left snuffbox approach is still concerned. We aimed to investigate efficacy and safety of the left snuffbox approach for CAG and PCI. Methods: Left snuffbox approach was tried in 150 patients who planned to perform CAG or PCI for suspected myocardial ischemia between 1 November 2017 and 31 March 2018. Results: Success rate of radial artery (RA) cannulation via snuffbox approach was 88.0% (n=132). Among 132 individuals, 58 (43.9%) acute coronary syndrome (ACS) patients were included. The diameter of snuffbox RA was significantly smaller than conventional RA (2.57 mm vs. 2.72 mm, p<0.001) from quantitative computed angiography of 101 patients. However, CAG via snuffbox approach by 6 French sheath was successfully performed in all 132 patients. In addition, there was significant correlation between the snuffbox and conventional RA diameter (r=0.856, p<0.001). In 42 PCI cases, including 25 patients with acute myocardial infarction (AMI), the success rate of PCI via snuffbox approach was 97.6% (n=41). Intravascular imaging-guided PCI was performed in 8 (19.5%) patients and multi-vessel PCI in 4 (9.8%) cases. Regarding vascular complication, forearm swelling with bruising, not requiring surgery or transfusion, occurred in 2 (4.9%) PCI cases. Conclusions: Left snuffbox approach is suitable for CAG and PCI compared with the conventional radial approach.

• Journal of Korean Academy of Nursing
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• v.48 no.1
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• pp.1-11
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• 2018

Purpose: The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG). Methods: A non-equivalent control group with a pretest-posttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney U Test and repeated-measures analysis of variance. Results: Significant interactions in the high frequency of ANS (F=5.58, p=.005) were observed between group and time. Stress index (z=2.14, p=.016), systolic blood pressure (z=4.14, p<.005), and diastolic blood pressure (z=3.28, p=.001) were significantly different between the experimental and control groups after 4 hours of treatment II. Conclusion: The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.719-728
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• 2019

Objective: To investigate the diagnostic validity of coronary computed tomography angiography (cCTA) in vasospastic angina (VA) and factors associated with discrepant results between invasive coronary angiography with the ergonovine provocation test (iCAG-EPT) and cCTA. Materials and Methods: Of the 1397 patients diagnosed with VA from 2006 to 2016, 33 patients (75 lesions) with available cCTA data from within 6 months before iCAG-EPT were included. The severity of spasm (% diameter stenosis [%DS]) on iCAGEPT and cCTA was assessed, and the difference in %DS (Δ%DS) was calculated. Δ%DS was compared after classifying the lesions according to pre-cCTA-administered sublingual nitroglycerin (SL-NG) or beta-blockers. The lesions were further categorized with %DS ≥ 50% on iCAG-EPT or cCTA defined as a significant spasm, and the diagnostic performance of cCTA on identifying significant spasm relative to iCAG-EPT was assessed. Results: Compared to lesions without SL-NG treatment, those with SL-NG treatment showed a higher Δ%DS (39.2% vs. 22.1%, p = 0.002). However, there was no difference in Δ%DS with or without beta-blocker treatment (35.1% vs. 32.6%, p = 0.643). The significant difference in Δ%DS associated with SL-NG was more prominent in patients who were aged < 60 years, were male, had body mass index < 25 kg/m², and had no history of hypertension, diabetes, or dyslipidemia. Based on iCAG-EPT as the reference, the per-lesion-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of cCTA for VA diagnosis were 7.5%, 94.0%, 60.0%, 47.1%, and 48.0%, respectively. Conclusion: For patients with clinically suspected VA, confirmation with iCAG-EPT needs to be considered without completely excluding the diagnosis of VA simply based on cCTA results, although further prospective studies are required for confirmation.

• Korean Journal of Adult Nursing
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• v.19 no.5
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• pp.47-55
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• 2007

Purpose: The purpose of this study was to determine the effect of supportive nursing care on the level of knowledge and compliance with sick-role behavior in patients with coronary artery disease after coronary angiography (CAG). Methods: A quasi-experimental research was performed with 81 subjects with coronary artery disease who were admitted for CAG to a cardiovascular department. Among the selected subjects, 40 of them were assigned to experimental group and the rest of them were assigned to control group by convenience. Supportive nursing care was implemented twice by a researcher. Results: 1. The mean score of knowledge related to coronary artery disease was higher in the group who received supportive nursing care than that of the control group (t=2.259, p=.027). 2. The mean score of compliance of sick role behavior was higher in the group who received supportive nursing care than that of the control group (t=4.580, p=.001). Conclusion: The supportive nursing care after CAG was effective in increasing the knowledge level and compliance of sick-role behavior in patients with coronary artery disease. Further studies would be recommended to identify long-term effectiveness of supportive care on patients' outcomes.

• Journal of Korean Biological Nursing Science
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• v.23 no.4
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• pp.308-317
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• 2021

Purpose: The purpose of this study was to elucidate the relationship between readiness to quit smoking and smoking cessation, and identify factors associated with smoking cessation in smokers with ischemic heart disease post-coronary angiography (CAG). Methods: This descriptive study was conducted between December 1, 2020 and May 14, 2021 at a P hospital, Busan. A total of 164 subjects completed the questionnaire including general characteristics, coronary artery disease characteristics, readiness to quit smoking, and smoking cession behavior during hospitalization and 4 weeks after discharge. Results: The success rate of smoking cessation after coronary angiography in patients with ischemic heart disease was 49.4% (n = 81). In addition, 48.2% of smokers (n = 83) attempted smoking cessation after CAG, while 39.8% showed changes in smoking behavior. The readiness to quit smoking was significantly associated with smoking cessation (OR= 2.23, p< .005). Conclusion: Readiness to quit smoking was identified as an important factor associated with smoking cessation in patients with cardiovascular disease in this study. In order to increase the smoking cessation rate, it is necessary to strengthen the readiness to quit smoking, followed by a tailored program for smoking cessation in patients with ischemic heart disease.

• 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.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.535-541
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• 2016

This study aimed to identify dose reduction measures by retrospectively analyzing the entrance surface dose at computed tomography and angiography in cardiovascular examination and to contribute the patients with renal impairmend and a high probability of side effects to determine the inspection's direction by measuring the contrast usages actually to active actions for the dose by actually measuring the contrast medium dose. The CTDIvol value and air kerma value, which are the entrance surface doses of the two examinations, and the contrast medium dose depending on the number of slides were compared and analyzed. This study was conducted in 21 subjects (11 males; 10 females) who underwent Cardiac Computed Tomographic Angiography (CCTA) and Coronary Angiography (CAG) in this hospital during the period from May 2014 to May 2016. The subject's age was 48~85 years old (mean $65{\pm}10$ years old), and the weight was 37.6~83.3 kg (mean $63{\pm}6kg$). Dose reduction could be expected in the cardiovascular examination using CCTA rather than in the examination using CAG. In terms of contrast medium dose, CAG used a smaller dose than CCTA. In particular, as the number of slides increases at CAG, the contrast medium dose increases. Therefore, in order to reduce the contrast medium dose, the number of slides suitable for the scan range must be selected.

• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.131-134
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• 2023

Here, we present a case of a 56-year-old man with acute myocardial infarction. The patient underwent percutaneous coronary intervention (PCI) at the left main bifurcation and mid-left anterior descending artery using drugeluting stents. Four months after the PCI, the patient was readmitted for cardiac arrest. Coronary angiography (CAG) revealed stent thrombosis in the left main-to-proximal left anterior descending artery and in-stent restenosis in the left main-to-proximal left circumflex artery. We performed balloon angioplasty at the left main to mid-left anterior descending artery and left main to proximal left circumflex artery stents; subsequently, blood flow was fully restored. However, contrast agent extravasation was observed outside the mid-portion of the left main artery to the proximal left anterior descending artery stent, indicating the presence of a coronary artery aneurysm (CAA) outside the stent. After guideline-directed medical therapy with dual antiplatelet agents and high-intensity statins, follow-up CAG revealed near-resolution of the CAA, absence of stenotic lesions, and good blood flow.

• International journal of advanced smart convergence
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• v.12 no.4
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• pp.134-141
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• 2023

We present a novel method aimed at refining ground truth data through regularization and modification, particularly applicable when working with the original ground truth set. Enhancing the performance of deep neural networks is achieved by applying regularization techniques to the existing ground truth data. In many machine learning tasks requiring pixel-level segmentation sets, accurately delineating objects is vital. However, it proves challenging for thin and elongated objects such as blood vessels in X-ray coronary angiography, often resulting in inconsistent generation of ground truth data. This method involves an analysis of the quality of training set pairs - comprising images and ground truth data - to automatically regulate and modify the boundaries of ground truth segmentation. Employing the active contour model and a recursive ground truth generation approach results in stable and precisely defined boundary contours. Following the regularization and adjustment of the ground truth set, there is a substantial improvement in the performance of deep neural networks.

• Journal of radiological science and technology
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• v.46 no.6
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• pp.509-517
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• 2023

This study analyzed imaging conditions and exposure index through clinical information collection and dose calculation programs in coronary angiography examinations. Through this, we aim to analyze the effective dose according to examination conditions and provide basic data for dose optimization. In this study, ALARA(As Low As Reasonably Achievable)-F(Fluoroscopy), a program for evaluating the radiation dose of patients and the collected clinical data, was used. First, analysis of imaging conditions and exposure index was performed based on the data of the dose report generated after coronary angiography. Second, after evaluating organ dose according to 9 imaging directions during coronary angiography, with the LAO fixed at 30°, dose evaluation was performed according to tube voltage, tube current, number of frames, focus-skin distance, and field size. Third, the effective dose for each organ was calculated according to the tissue weighting factors presented in ICRP(International Commission on Radiological Protection) recommendations. As a result, the average sum of air kerma during coronary angiography was evaluated as 234.0±112.1 mGy, the dose-area product was 25.9±13.0 Gy·cm², and the total fluoroscopy time was 2.5±2.0 min. Also, the organ dose tended to increase as the tube voltage, milliampere-second, number of frames, and irradiation range increased, whereas the organ dose decreased as the FSD increased. Therefore, medical radiation exposure to patients can be reduced by selecting the optimal tube voltage and field size during coronary angiography, maximizing the focal-skin distance, using the lowest tube current possible, and reducing the number of frames.