• Title/Summary/Keyword: Coronary thrombosis

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Coating defects in polymer-coated drug-eluting stents

  • Bedair, Tarek M.;Cho, Youngjin;Park, Bang Ju;Joung, Yoon Ki;Han, Dong Keun
    • Biomaterials and Biomechanics in Bioengineering
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    • v.1 no.3
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    • pp.131-150
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    • 2014
  • Vascular stenting has a great attention as a treatment for coronary arteries diseases as compared with percutaneous balloon angioplasty. In-stent restenosis and thrombosis are side effects resulting from using bare metal stent (BMS). Employing platelet therapy allowed to reduce the rate of thrombosis, however, the rate of restenosis remains a major problem. In 2002, drug-eluting stents (DESs) were introduced as an effort to reduce the restenosis. The commercially available DESs continue to suffer from coating defects that might lead to a series of adverse effects. Most importantly, multiple concerns remain regarding the polymer coating integrity on metal surfaces or the relation of polymer irregularities to longterm adverse events.

Effect of Simultaneous Use of Platelet Glycoprotein IIb / IIIa Receptor Blocker and Thrombus Aspiration in Patients with Coronary Artery Stent Thrombosis (관상동맥 스텐트 혈전증 환자에서 혈소판 당단백 IIb/IIIa 수용체 차단제와 혈전흡입술 동시시행의 임상결과)

  • Kim, In Soo;Choi, Nam Gil;Kong, Chang gi;Eun, Sung jong;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.359-369
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    • 2019
  • To evaluate the effect of simultaneous use of platelet glycoprotein IIb / IIIa receptor blocker and catheter assisted thrombus aspiration in the treatment of coronary stent thrombosis. 267 patients ($64.6{\pm}12.1years$, 187 men) with stent thrombosis on coronary angiography at Chonnam National University Hospital from July 2008 to July 2017 were enrolled. We devided two groups based on treatment modalities: Group I (N=32, platelet glycoprotein IIb / IIIa receptor blocker and thrombo-aspiration), Group II (N =235, either platelet glycoprotein IIb /IIIa receptor blocker or thrombo-aspiration, or none of both), and the major cardiac events including death, revascularization and stent thrombosis were followed up for 1 year. There were no significant differences in clinical characteristics between the two groups including age (Group I: $60.8{\pm}12.9$ vs. Group II: $65.1{\pm}11.9$, p= 0.603), male (Group I: 75.0% vs. Group II: 69.4%, p=0.681), and left ventricular ejection fraction (Group I: $58.1{\pm}9.0%$ vs. Group II: $59.5{\pm}11.9%$, p= 0.127). The major cardiac events did not differ between the two groups (Group I: 12.5% vs. Group II: 23.8%, p=0.180). The secondary endopoints were as followings: The mortality rate (Group I: 0% vs. 13.2%, Group II: p=0.034), target lesion revascularization (Group I: 9.4% vs Group II: 6.4%, p=0.461) and stent thrombosis (Group I: 3.1% vs. Group II: 4.7%, p=1.000). In conclusion, in the treatment of coronary artery stent thrombosis, simultaneous use of platelet glycoprotein IIb / IIIa receptor blocker and thrombus aspiration was associated with better clinical outcomes regarding 1 year mortality.

Clinical Outcomes of Stent Thrombosis after Drug-Eluting Coronary Stent Implantation (약물방출 관상동맥 스텐트 시술 후 스텐트 혈전증 발생 환자의 임상경과)

  • Kim, In-Soo;Jeong, Myoung-Ho;Han, Jae-Bok;Jang, Young Ill;Jang, Seong-Joo
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.880-892
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    • 2013
  • Stent thrombosis after successful drug-eluting stent(DES) implantation has been reported in around 1% of patients in clinical trials. However, the increased risk of ST associated with DES remains a matter of concern. From 1 June 2003 to 30 June 2013, we investigated clinical characteristics, in-hospital outcomes in 10,273 patients who underwent percutaneous coronary intervention in the Heart Center of CNUH. Overall incidence of ST was 1.30% (134 patients). The incidence of ST according to the stent generations and the timing of ST (n=total, early vs. late vs. very late) were 0.79% (n=81, 26 vs. 12 vs. 43) in first-generation, 0.38% (n=39, 21 vs. 9 vs. 9) in second-generation and 0.14% (n=14, 8 vs 3 vs. 3) in third-generation, (p=0.70). The mortality from ST was significantly higher in early ST group compared to the late and very late ST groups (18.2% vs. 8.3% vs. 3.6%, p=0.042). Overall incidence of ST after DES implantation was 1.30% (134 patients). The in-hospital mortality was significantly higher in early ST group compared to the late and very late ST groups.

Myocardial Revascularization in Two Patients Associated with Antiphospholipid Syndrome: Different Pathogenic Patterns and Angiographic Results

  • Park, Samina;Hwang, Ho-Young;Kang, Hyun-Jae;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.423-426
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    • 2011
  • We report on two women who underwent myocardial revascularization associated with antiphospholipid syndrome (APS) with different pathogenic patterns. The first woman presented with acute myocardial infarction, and preoperative angiograms demonstrated rapidly progressing coronary lesions, presumptive unstable plaque, and dissection. Operative findings, however, showed fresh thrombi in the coronary arteries, and she was diagnosed postoperatively as having APS. Her one-year angiogram demonstrated improved coronary lesions and a competitive flow pattern in the grafts. The second woman presented with unstable angina and had been treated for systemic lupus erythematosus and secondary APS for more than 14 years. She underwent myocardial revascularization due to accelerated coronary atherosclerosis. Her one-year angiogram demonstrated patent grafts.

Acute Myocardial Infarction caused by Left Coronary Artery Aneurysm following Blunt Chest Trauma - A case report - (흉부 둔상 후 발생한 좌측 관상동맥 동맥류에 의한 급성 심근경색증 - 1예 보고 -)

  • Park, Il-Hwan;Yoo, Kyung-Jong;Oh, Joong-Hwan
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.228-231
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    • 2007
  • Chest trauma can lead to various cardiac complications ranging from arrythmia to myocardial rupture. Coronary artery injury in patients with blunt chest trauma is rare, and traumatic aneurysm of the left coronary artery is even more unusual than right coronary artery. Injury to the coronary arteries, including intimal aneurysm, dissection, laceration, arteriovenous fistula and thrombosis, are sequelae that rarely occur after a blunt trauma. Occlusion of the coronary artery results is a serious complication for the patient via acute myocardial infarction, We report here on a case of acute myocardial infarction with coronary artery aneurysm that arose from blunt chest trauma in a 33-year-old male, and he was successfully managed by a coronary bypass graft without performing cardiopulmonary bypass.

Acute Myocardial Infarction after Embolic Occlusion of Left Anterior Descending Artery by Prosthetic Valve Thrombosis - Report of 1 case - (인공판막 혈전에 의한 좌전하행지 폐쇄 후 급성심근경색 -1예 보고-)

  • 김재현;임달수;오삼세;백만종;김종환;나찬영
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.369-372
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    • 2004
  • Acute myocardial infarction due to coronary occlusion by emboli originating from the prosthetic valve thrombosis is very rare but fatal disease which needs immediate diagnosis and urgent treatment. We report a case of acute myocardial infarction after left anterior descending embolic occlusion in whom had previous mitral valve replacement. Redo valve replacement following the interventional catheterization and anti platelet therapy lead to successful results.

Guide wire fracture during percutaneous coronary intervention (경피적 관상동맥 확장 성형술 도중 우관상동맥 뒤가쪽가지에서 발생한 유도철사 부러짐)

  • Kim, Hak Ro;Yim, Tae Hoon;Kim, Byung Chul;Lee, Ho Jun;Oh, Hong Geun;Ju, Hyun Sik;Kim, Tae Jin;Kim, Young Bok
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.52-55
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    • 2016
  • Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.

The Developing Trend in Bioresorbable Stent for Treatment of Coronary Artery Disease (관상동맥질환 치료를 위한 생체흡수형스텐트의 개발 동향)

  • Jeong, Gyeong-Won;Kim, Tae-Hoon;Nah, Jae-Woon;Park, Jun-Kyu
    • Applied Chemistry for Engineering
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    • v.29 no.5
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    • pp.497-502
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    • 2018
  • The coronary artery disease (CAD) is rapidly increasing such as angina pectoris and atherosclerosis. The CAD is induce by cholesterol and calcium like plaque absortion to artery wall. The percutaneouss coronary intervention is non-invasive treatment that narrowed-artery is expand by using balloon catheter and bare metallic stent. The metallic stents have been effective in reducing the dead by coronary artery disease, but the permanent presence of the metallic stent has been associated with persistent inflammation, and incidence of late thrombosis. Therefore, development bioresorbable vascular scaffold (BRS) is rapidly increasing for treatment of long-term complications and arterial restenosis by permanentmetal prosthesis such as stent. The review discusses the BRS trend for successfully development.

A Case of Multiple Giant Coronary Aneurysms with Large Mural Thrombus due to Kawasaki Disease in a Young Infant (가와사끼병 영아에서 발생한 혈전을 동반한 거대관상동맥류 1례)

  • Choi, Eun Na;Kim, Jeoung Tae;Kim, Yuria;Yoo, Byung Won;Choi, Deok Young;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kye;Kim, Dong Soo;Park, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.321-326
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    • 2005
  • Kawasaki disease is an acute systemic vasculitis of unknown origin. Giant coronary aneurysm is one of the most serious complications, although peripheral artery vasculitis can produce life-threatening events. Myocardial ischemia and infarction can be caused by coronary artery stenosis, aneurysm, and stagnation of blood flow in coronary arteries which triggers thromboembolism. Atypical presentation in young infants often interferes with prompt diagnosis and timely treatment, resulting in poor outcomes. We describe a 3-month-old infant with multiple giant coronary aneurysms with flow stagnation, stenosis and large mural thrombus due to Kawasaki disease. He presented with a prolonged course of severe coronary involvement in spite of all measures to reduce coronary complications. Finally, surgical intervention was tried because of the worsening coronary artery abnormalities. The patient died of acute cardiorespiratory failure shortly after weaning from cardiopulmonary bypass.

Regional Myocardial Blood Flow Estimation Using Rubidium-82 Dynamic Positron Emission Tomography and Dual Integration Method (Rubidium-82 심근 Dynamic PET 영상과 이중적분법을 이용한 국소 심근 혈류 예측의 기본 모델 연구)

  • 곽철은;정재민
    • Journal of Biomedical Engineering Research
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    • v.16 no.2
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    • pp.223-230
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    • 1995
  • This study investigates a combined mathematical model for the quantitative estimation of regional myocardial blood flow in experimental canine coronary artery occlusion and in patients with ischemic myocardial diseases using Rb-82 dynamic myocardial positron emission tomography. The coronary thrombosis was induced using the new catheter technique by narrowing the lumen of coronary vessel gradually, which finally led to partial obstruction of coronary artery. Thirty four Rb-82 dynamic myocardial PET scans were performed sequentially for each experiment using our 5, 10 and 20 second acquisition protocol, respectively, and six to seven regions of interest were drawn on each transaxial slices, one on left ventricular chamber for input function and the others on normal and decreased perfusion myocardial segments for the flow estimation in those regions. Two compartment model and graphical analysis method have been applied to the measured sets of regional PET data, and the rate constants of influx to myocardial tissue were calculated for regional myocardial flow estimates with the two parameter fits of raw data by the Levenberg-Marquardt method. The results showed that, (I) two compartment model suggested by Kety-Schmidt, with proper modification of the measured data and volume of distribution, could be used for the simple estimation of regional myocardial blood flow, (2) the calculated regional myocardial blood flow estimates were dependent on the selection of input function, which reflected partial volume effect and left ventricular wall motion in previously used graphical analysis, and (3) mathematically fitted input and tissue time activity curves were more suitable than the direct application of the measured data in terms of convergence.

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