• 대한핵의학회:학술대회논문집
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• 대한핵의학회 2001년도 제40차 춘계학술대회 및 연수교육
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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.

• 문화기술의 융합
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• 제6권4호
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• pp.231-244
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• 2020

본 연구는 관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향을 미치는 심리사회적 요인을 분석하기 위해 수행된 서술적 조사연구이다. 경상남도 J시 G대학교병원에서 관상동맥중재술을 받고 외래를 내원한 환자 126명을 대상으로 2018년 7월 15일부터 10월 2일까지 구조화된 설문지를 사용하여 자료수집 후 SPSS/WIN 21.0으로 통계 분석하였다. 분석결과 대상자 특성에 따른 건강행위 이행은 배우자 유무, 교육수준, 주관적 건강상태, 주관적 삶 만족도에 따라 차이가 있었으며, 의료인 지지, 회복탄력성에서는 정적 상관관계가 있었고, 지각된 스트레스, 지각된 스트레스의 하위영역인 가족관계, 불안과 위축, 빈곤과 재정, 우울과는 부적 상관관계가 있었다. 다중회귀분석 결과 회복탄력성, 지각된 스트레스의 하위영역인 빈곤과 재정, 교육수준, 주관적 삶 만족도가 관상동맥중재술을 받은 노인의 건강행위 이행을 27.9% 설명하는 것으로 나타났다. 이러한 결과를 기반으로 관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행을 향상시키기 위한 간호중재 프로그램 개발과 적용이 필요하다.

• Journal of Chest Surgery
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• 제49권sup1호
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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.

• 성인간호학회지
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• 제20권3호
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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.

• 한국임상약학회지
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• 제22권2호
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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.

• 대한한방내과학회지
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• 제42권2호
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• pp.184-196
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• 2021

Objectives: This case report presents the effects of Korean medical treatment in a patient with chest pain after percutaneous coronary intervention (PCI). Methods: An 80-year-old woman was treated with Korean herbal medicine, acupuncture, and cupping therapy. Chest pain, sore tongue, and headache were assessed daily using a numeric rating scale (NRS). Results: After 15 days of treatment, chest pain disappeared, as reflected by an NRS change from 9 to 0, and headache was relieved (NRS decreased from 9 to 2). On the eighth day of treatment, the sore tongue was also relieved, as reflected by an NRS change from 9 to 0. Conclusion: These results show that chest pain after PCI can be relieved with Korean medical treatment, and it is expected that major adverse cardiac events (MACEs) may be prevented with Korean medical treatment. However, additional well-designed studies are required to confirm these findings.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.46-56
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• 2022

The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1999년도 제38차 춘계학술대회
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• pp.228-241
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• 1999

Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, intimal hyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of post PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.

• Journal of Chest Surgery
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• 제41권2호
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• pp.210-215
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• 2008

배경: 약물방출스텐트에 의한 재협착감소효과와 병행약물치료의 발달은 좌주간지병변에 대한 스텐트 시술의 증가를 가져오고 있다. 본 연구는 좌주간지병변에 대한 관상동맥우회수술과 약물방출스텐트 시술의 1년 임상성적을 비교하였다. 대상 및 방법: 본원에서 좌주간지병변으로 관상동맥우회수술이나 약물방출스텐트 삽입술을 받은 환자를 우회수술군과 스텐트군으로 나누어 이들 군의 수술 전 관상동맥질환 및 중증도, 입원기간, 원내 사망, 1년간 누적 사망 및 심근경색발생, 재관류술 시행비율 등을 비교 조사하였다. 결과: 101명의 관상동맥우회수술을 받은 환자(수술군)와 78명의 스텐트 시술을 받은 환자(스텐트군)가 분석대상이었다. 양군 환자의 연령, 성별, 위험인자, 좌심실 구혈률, 급성관 상동맥증후군의 비율에 있어서 차이가 없었다. 수술 군의 Euroscore가 $26.0{\pm}20.4$로 스텐트 군에 비해 높아 더 위험군이었으며(vs $6.38{\pm}10.31$, p<0.001), 긴급성도 37.6%로 더 많았으며(vs 10.3%, p<0.001) 입원기간도 16.1일로서 더 길었다(vs 7.9일, p=0.001). 좌주간지 이외 다혈관질환을 가지고 있는 경우도 수술군이 많았다(92.1% vs 37.2%, p<0.001). 원내 사망률과 1년 누적사망율에 있어서 차이가 없었다(3.0% vs 2.6%; 5.2% vs 6.6%, p=0.73). Euroscore로 matching한 41명의 수술환자와 78명의 스텐트환자를 선별하여 분석하였을 때 Euroscore (9.1 vs 6.4, p=0.104) 연령, 성별, 위험인자, 급성 관상동맥증후군의 비율의 차이는 없었다. Euroscore matched 분석에서 수술군에서 다혈관질환이 많았으며(87.8% vs 37.2%, p<0.001) 입원기간도 더 길었다(13.3일 vs 7.9일, p=0.02). 원내사망률과 1년 누적사망율은 수술군이 우수한 경향이 있었으나 통계적으로 유의하지는 않았다(0% vs 2.6%, p=0.55; 0% vs 6.6%, p=0.30). Euroscore matched 분석에서 1년 재관류술 비율은 스텐트군과 수술군에서 각각 13.3%와 6.3% (p=0.48), 사망 혹은 심근경색증 발생비율은 10.0%와 0% (p=0.09)였다. 결론: 저위험군 환자의 화주간지병변에 대한 약물방출스텐트 시술은 수술에 비해 입원기간 단축의 효과는 있지만, 추적관찰기간동안 재관류술 시행비율과 1년 누적 사망률이 증가하는 경향을 보이고 있으며, 보다 많은 환자를 대상으로 한 장기적 관찰이 필요하다.

• Journal of Chest Surgery
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• 제50권2호
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• pp.105-109
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• 2017

Coronary arterial involvement in Takayasu arteritis (TA) is not uncommon. Herein, we describe a case of TA with celiac trunk and superior mesenteric artery occlusion combined with coronary artery disease. Bilateral huge internal thoracic arteries (ITAs) and the inferior mesenteric artery provided the major visceral collateral circulation. After percutaneous intervention to the right coronary artery, off-pump coronary artery bypass grafting for the left coronary territory was done using a right ITA graft and its large side branch because of its relatively minor contribution to the visceral collateral circulation.