• Journal of Yeungnam Medical Science
• /
• 제35권2호
• /
• pp.227-231
• /
• 2018

Left main coronary artery (LMCA) thrombosis is rare and the cause should be determined. A previously healthy young man presented with severe chest pain and dyspnea. The electrocardiogram showed typical ST-segment elevation myocardial infarction with clinical instability. Emergency coronary angiography revealed complete LMCA occlusion by thrombosis. After reperfusion, the patient was admitted to the cardiac care unit. He was diagnosed with hemolytic anemia and tested positive for antinuclear antibodies. Systemic lupus erythematosus (SLE) and LMCA disease due to systemic thrombosis were diagnosed. Steroids were started and the patient was discharged without complications. We report this rare case of LMCA thrombosis as an initial presentation of SLE.

• Journal of Chest Surgery
• /
• 제22권3호
• /
• pp.456-462
• /
• 1989

We experienced one case of the calcified giant thrombosis in the enlarged right atrium and coronary sinus with markedly dilated persistent left superior vena cava and absent right superior vena cava in 29year old female patient. We supposed that the dilatation of persistent left superior vena cava was due to poststenotic dilatation secondary to obstruction on orifice of coronary sinus by thrombosis. The giant thrombosis in the right atrium and coronary sinus was successfully resected. She had improvement on preoperative chest discomfort but, the moderate hepatomegaly was developed and then she was discharged with incompletely recovered state due to economical poverty on postoperative 6th weeks. The continuous follow-up and study are indeed necessary for further evaluation of pathology and etiology.

• Clinical and Experimental Pediatrics
• /
• 제46권3호
• /
• pp.302-307
• /
• 2003

환아는 3개월된 영아로 발병 10일째에 본원에 내원하여 초기에 적절한 진단과 치료를 받지 못했으며 발병 2주에 시행한 심초음파상 거대 관상동맥류를 보였다. 이에 정맥용 면역글로불린 투여와 aspirin과 dipyridamole로 치료 중 발병 24일째 혈전증이 동반되어 urokinase와 heparin의 IV 투여를 통한 혈전용해 치료로 혈전을 완전히 제거할 수 있었다. 이후 5년간 aspirin, dipyridamole, coumadin을 투여하면서 심전도와 심초음파검사를 반복하며 외래 추적 관찰 중 점차 좌측관상동맥내 혈전이 증가하고 내경이 점차 좁아지는 소견과 함께 협착이 의심되었다. 발병 5년 후 시행한 관상동맥 혈관조영술상 관상동맥 좌측 전하지가 완전 폐색되고 우측관상동맥으로부터 발달한 측부순환에서 혈류를 공급받고 있었고, 핵의학 검사상 좌심실의 전벽과 중격, 일부 외벽에 완전 가역적 관류 결손을 보였던 가와사끼병 환아 1례를 경험하여 보고한다.

• 한국임상약학회지
• /
• 제22권2호
• /
• pp.113-122
• /
• 2012

ACC/AHA/SCAI Guideline recommends for administration dual antiplatelet therapy after drug-eluting stent (DES) to prevent restenosis and stent thrombosis in patients with percutaneous coronary intervention (PCI). Recently triple antiplatelet therapy including cilostazol is known to reduce restenosis and stent thrombosis significantly after DES implantation. However, there is lack of data providing the efficacy of triple antiplatelet therapy. The purpose of this study is to evaluate the clinical effects of the triple therapy after DES implantation compared with the dual therapy. This retrospective study collected data from medical charts of 251 patients who received DES implantation between Jul 2006 and Jun 2008. They received either dual antiplatelet therapy (N = 154 clopidogrel and aspirin; Dual group) or triple antiplatelet therapy (N = 97 cliostazol, clopidogrel and aspirin; Triple group). Major adverse cardiac event rates (MACE, included total death, myocardial infarction, target lesion revascularization) at 12 months, 24 months, stent thrombosis, rates of bleeding complications and adverse drug reactions were compared between these two groups. Compared with the dual group, the triple group had a similar incidence of the MACE rates at 24months (12.3% vs. 12.4%, p = 0.99). There is no difference in overall stent thrombosis between two groups (Dual group 2.6% vs. Triple group 4.1%, p = 0.5). Subgroup analysis showed that diabetic patients got more benefit in reducing MACE rates but, there is no statistical difference. Bleeding complications and adverse drug effects were not different significantly. As compared with dual antiplatelet therapy, triple antiplatelet therapy did not reduce the 12-months, 24-months MACE rates and stent thrombosis. Bleeding complications and adverse drug effects were not different.

• Animal cells and systems
• /
• 제7권3호
• /
• pp.255-259
• /
• 2003

Mutations in the factor Ⅴ gene are major risk markers for venous thrombosis. Several factors for blood coagulation have been related with cardiovascular disease. Ⅰ investigated genotype distribution for three mutations (G1691 A, A2379G and G2391 A) of the factor Ⅴ gene in the Korean population. Genotype frequencies were examined by polymerase chain reaction in 135 patients with coronary artery disease (CAD) and 116 healthy subjects. For the G1691A mutation (factor Ⅴ

• Journal of Medicine and Life Science
• /
• 제20권3호
• /
• pp.131-134
• /
• 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.

• Journal of Chest Surgery
• /
• 제47권1호
• /
• pp.43-46
• /
• 2014

Phlegmasia cerulea dolens (PCD) is one of the most critical disorders of acute deep vein thrombosis in that it can cause permanent disability secondary to the compartment syndrome. Although several etiological factors have been proposed, PCD after coronary artery bypass surgery is extremely rare and its definitive pathophysiology is still under debate. We herein present a case of PCD that resulted in the compartment syndrome after coronary artery bypass surgery. Early recognition and decompression of PCD are crucial for saving the affected limbs.

• Nuclear Medicine and Molecular Imaging
• /
• 제40권2호
• /
• pp.113-119
• /
• 2006

Coronary artery disease is a loading cause of morbidity and mortality across the world. Percutaneous coronary intervention has become the major technique of revascularization. However, restenosis remains a major limitation of this procedure. Recently the need for repeat intervention due to restenosis, the most vexing long-term failure of percutaneous coronary intervention, has been significantly reduced owing to the introduction of two major advances, intracoronary brachytherapy and the drug-eluting stents. Intracoronary brachytherapy has been employed in recent years to prevent restenosis lesions with effective results, principally in in-stent restenosis. Restenosis is generally considered as au excessive form of normal wound healing divided up in precesses: elastic recoil, neointimal hyperplasia, and negative vascular remodeling. Restenosis has previously been regarded as a proliferative process in which neointimal thickening, mediated by a cascade of inflammatory mediators and other factors, is the key factor. Ionizing radiation has been shown to decrease the proliferative response to injury in animal models of restenosis. Subsequently, several randomized, double blind trials have demonstrated that intracoronary brachytherapy can reduce the rates of both angiographic restenosis and clinical event rates in patients undergoing percutaneous coronary intervention for in stent restenosis. Some problems, such as late thrombosis and edge restenosis, have been identified as limiting factors of this technique. Brachytherapy is a promising method of preventing and treating coronary artery restenosis.

• 대한핵의학회지
• /
• 제29권1호
• /
• pp.48-53
• /
• 1995

Rb-82 dynamic PET과 이중적분법에 의한 국소 심근 혈류측정 연구를 시행하고자 실험 개를 이용한 심근 혈전증 모델에서 좌심실 입력함수에 의한 정상 및 관류결손 심근에서의 혈류를 측정하였다. 이중적분법이 선형회귀모델에 의한 혈류측정방법에 비하여 실현이 간단하고 심근내 혈류가 선형적인 가정을 배제할 수 있어 더욱 정확한 방법이 될 수 있음을 확인하였다.

• Journal of Chest Surgery
• /
• 제39권5호
• /
• pp.399-402
• /
• 2006

스텐트 혈전증은 경피적 관상동맥 중재술의 드문 합병증으로 치명적인 결과를 일으킬 수 있다. 저자들은 스텐트 혈전에 의한 심인성 쇼크와 심실성 빈맥이 동반된 급성 심근경색 환자 1예를 경피적 심폐 순환 보조 요법으로 성공적으로 치료하였기에 보고하고자 한다.