• Title/Summary/Keyword: Percutaneous Coronary Intervention

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Clinical Applications of Intracoronary OCT (Invited Paper) (심혈관 OCT의 임상적 응용)

  • Ha, Jinyong;Kim, Jung-Sun;Hong, Myeong-Ki
    • Korean Journal of Optics and Photonics
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    • v.26 no.1
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    • pp.1-8
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    • 2015
  • The most common cause of a heart attack is known as coronary artery disease, which narrows the arteries and reduces the blood flow to the heart. To treat coronary artery stenosis, percutaneous coronary intervention (PCI) (a nonsurgical procedure to install a stent, which holds the artery wall open) is performed. Intracoronary optical coherence tomography (OCT) is a catheter-based, invasive optical imaging system. To determine whether PCI is appropriate, and to perform stent evaluation in a catheterization laboratory, OCT examinations are carried out. This review details the fundamental principles and technological status of intracoronary OCT imaging, and discusses the ongoing clinical applications to determine the benefits of OCT-guided PCI.

Functional Angioplasty: Definitions, Historical Overview, and Future Perspectives

  • Hanbit Park;Do-Yoon Kang;Cheol Whan Lee
    • Korean Circulation Journal
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    • v.52 no.1
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    • pp.34-46
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    • 2022
  • Percutaneous coronary intervention (PCI) is used to treat obstructive coronary artery disease (CAD). The role of PCI is well defined in acute coronary syndrome, but that for stable CAD remains debatable. Although PCI generally relieves angina in patients with stable CAD, it may not change its prognosis. The extent and severity of CAD are major determinants of prognosis, and complete revascularization (CR) of all ischemia-causing lesions might improve outcomes. Several studies have shown better outcomes with CR than with incomplete revascularization, emphasizing the importance of functional angioplasty. However, different definitions of inducible myocardial ischemia have been used across studies, making their comparison difficult. Various diagnostic tools have been used to estimate the presence, extent, and severity of inducible myocardial ischemia. However, to date, there are no agreed reference standards of inducible myocardial ischemia. The hallmarks of inducible myocardial ischemia such as electrocardiographic changes and regional wall motion abnormalities may be more clinically relevant as the reference standard to define ischemia-causing lesions. In this review, we summarize studies regarding myocardial ischemia, PCI guidance, and possible explanations for similar findings across studies. Also, we provide some insights into the ideal definition of inducible myocardial ischemia and highlight the appropriate PCI strategy.

Trapped Stent in the Left Coronary Sinus in a Myocardial Infarction Patient

  • Han, Sun;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.368-370
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    • 2015
  • Stent entrapment is a very rare complication of percutaneous coronary intervention. The interventional approach could be a treatment strategy. However, if it does not work, surgical treatment should be considered. Here, we report a case of surgical treatment of stent entrapment in the left coronary sinus of a 53-year-old male patient.

Cardiac arrest due to an unexpected acute myocardial infarction during head and neck surgery: A case report

  • Kim, Jimin;So, Eunsun;Kim, Hyun Jeong;Seo, Kwang-Suk;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.1
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    • pp.57-64
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    • 2018
  • Major cardiac complication such as acute myocardial infarction can occur unexpectedly in patients without risk factors. We experienced cardiac arrest due to an unexpected acute myocardial infarction in a patient without any risk factors during head and neck reconstructive surgery. The patient was diagnosed with acute myocardial infarction after return of spontaneous circulation. With immediate percutaneous coronary intervention, the patient recovered without complications.

Intracoronary Radiation Therapy (관동맥혈관 내 방사선 근접 치료)

  • Moon, Dae-Hyuk;Park, Seong-Wook;Hong, Myeong-Ki;Oh, Seung-Jun;Bom, Hee-Seung;Lee, Hee-Kyung
    • 대한핵의학회:학술대회논문집
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    • 2001.05a
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    • pp.24-34
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    • 2001
  • Restenosis remains a major limitation of percutaneous coronary interventions. Numerous studios including pharmacological approaches and new devices failed to reduce the restenosis rate except coronary stenting. Since the results of $BENESTENT^{1)}\;and\;STRESS^{2)}$ studies came out, coronary stenting has been the most popular interventional strategy in the various kinds of coronary stenotic lesions, although the efficacy of stenting was shown only in the discrete lesion of the large coronary artery. The widespread use of coronary stenting has improved the early and late outcomes after coronary intervention, but it has also led to a new and serious problem, e.g., in-stent restenosis. Intravascular radiation for prevention of restenosis is a new technology in the field of percutaneous coronary intervention. Recent animal experiments and human trials have demonstrated that local irradiation, in conjunction with coronary interventions, substantially diminished the rate of restenosis. This paper reviews basic radiation biology of intracoronary radiation and its role in the inhibition of restenosis. The current status of intracoronary radiation therapy using Re-188 liquid balloon is also discussed.

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Analysis of Psychosocial Factors Affecting Health Behavior Adherence among Community-dwelling Older Adults undergoing Percutaneous Coronary Intervention (관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향 미치는 심리사회적 요인 분석)

  • Jeon, Hye-Won;Chang, Hee-Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.231-244
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    • 2020
  • This study is a descriptive research to analyze psychosocial factors affecting health behavior adherence among community-dwelling older adults undergoing Percutaneous Coronary Intervention. Data were collected with structured questionnaires from 126 patients discharged after hospitalization from a university hospital in J city, Gyeongnam, from July 15 to October 2 in 2018, and analyzed using SPSS/WIN 21.0. The result shows that the general characteristics, such as existence of spouse, education level, subjective health status, and subjective life satisfaction, have a significant influence on health behavior adherence. The research also identifies that medical support and resilience are positively correlated with health behavior adherence. In contrast, perceived stress, 3 sub-categories from perceived stress such as, family relations, anxiety and withdrawal, poverty and finance, and depression are negatively correlated. In the multiple regression analysis, resilience, perceived stress from poverty and finance, education level, and subjective life satisfaction explained 27.9% of health behavior adherence among older adults undergoing Percutaneous Coronary Intervention. Based on the results of this study, it is necessary to develop and apply a nursing intervention program to improve the health behavior adherence of local older adults who had Percutaneous Coronary Intervention.

Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery in Korea

  • Lee, Heeyoung;Lee, Kun Sei;Sim, Sung Bo;Jeong, Hyo Seon;Ahn, Hye Mi;Chee, Hyun Keun
    • Journal of Chest Surgery
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    • v.49 no.sup1
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    • pp.60-67
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    • 2016
  • Background: Coronary angioplasty has been replacing coronary artery bypass grafting (CABG) because of the relative advantage in terms of recovery time and noninvasiveness of the procedure. Compared to other Organization for Economic Cooperation and Development (OECD) countries, Korea has experienced a rapid increase in coronary angioplasty volumes. Methods: We analyzed changes in procedure volumes of CABG and of percutaneous coronary intervention (PCI) from three sources: the OECD Health Data, the National Health Insurance Service (NHIS) surgery statistics, and the National Health Insurance claims data. Results: We found the ratio of procedure volume of PCI to that of CABG per 100,000 population was 19.12 in 2014, which was more than triple the OECD average of 5.92 for the same year. According to data from NHIS statistics, this ratio was an increase from 11.4 to 19.3 between 2006 and 2013. Conclusion: We found that Korea has a higher ratio of total procedure volumes of PCI with respect to CABG and also a more rapid increase of volumes of PCI than other countries. Prospective studies are required to determine whether this increase in absolute volumes of PCI is a natural response to a real medical need or representative of medical overuse.

The Effect of Hand Massage on Discomfort in Patients Following Percutaneous Coronary Intervention (손마사지가 경피적관상동맥중재술 환자의 불편감에 미치는 효과)

  • Kim, Yeo-Jin;Chung, Seung-Hee;Suh, In-Sun
    • Korean Journal of Adult Nursing
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    • v.20 no.3
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    • pp.452-460
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    • 2008
  • Purpose: This study assessed the effectiveness of hand massage on reducing discomfort of patients undergoing percutaneous coronary intervention(PCI). Methods: The sample consisted of 62 patients admitted to an university affiliated hospital. The 30 patients in experimental group received hand massage developed by Snyder(1995) for 5 minutes on both hands and 32 patients in control group received the usual nursing intervention only. The outcome variable of discomfort was measured 10 minutes before and after the hand massage using Questionnaire and VAS. The data were collected from Feb. 5th to May 17th in 2007, and analysed through Chi-square, and t-test with SPSS WIN 12.0. Results: The level of discomfort measured with the questionnaire was decreased in experimental group, but increased in control group. This discomfort changes in two groups were significantly different(t=4.43, p<.001). The level of discomfort measured with VAS was also decreased in experimental group, but increased in control group. The changes were significant, too(t=5.62, p<.001). Conclusion: It was clear that hand massage could be a useful nursing intervention in reducing the discomfort of patients undergoing PCI.

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Effect of Triple Compared to Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Percutaneous Coronary Intervention (관상동맥 약물 용출 스텐트 삽입 후 항혈소판제제 3제요법과 2제요법의 임상적 효과 비교)

  • Ye, Kyong-Nam;Kim, Jeong-Tae;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.113-122
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    • 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.