• 제목/요약/키워드: Percutaneous Coronary Intervention

검색결과 137건 처리시간 0.028초

관상동맥 CT 조영술을 활용한 스텐트 재협착 평가: 과거와 현재 최신 동향으로의 여정 (Coronary CT Angiography-Based Assessment of Coronary in-Stent Restenosis: A Journey through Past and Present Trends)

  • 이윤성;박은아;이활
    • 대한영상의학회지
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    • 제85권2호
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    • pp.258-269
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    • 2024
  • 관상동맥병 환자의 치료에 풍선팽창스텐트 치료는 현재 가장 흔히 시행되는 관상동맥재개통 치료법이다. 그러나 경피적 관상동맥 중재술 이후 재협착은 여전히 주요 합병증으로 남아 있다. 스텐트 재협착을 진단하기 위한 도구로서 관상동맥 CT 조영술(coronary CT angiography; 이하 CCTA)는 과거에는 주로 번짐허상과 움직임허상으로 인해 내강을 정확히 판단하기 어려워 그 역할이 제한적이었다. 따라서 정확한 확인을 위해서 침습적인 고식적 관상동맥 조영술로 넘어가는 경우가 많았다. 그러나 근래 CT 기술의 발달로 민감도와 특이도가 모두 개선되면서 그 역할이 중요해지고 있으며, 특히 일관되게 음성예측도가 높게 보고되고 있다. 본 종설에서는 CCTA를 이용한 관상동맥 스텐트 재협착 진단의 과거와 현재, 그리고 최신 동향에 대해 알아보고자 한다.

관상동맥질환자의 건강 임파워먼트, 배우자지지, 외상 후 성장이 건강증진행위에 미치는 영향 (Influence of Health Empowerment, Spousal Support, and Post-traumatic Growth on Health Behavior in Patients with Coronary Artery Disease)

  • 정은;이경심;양승경;조장현
    • Journal of Korean Biological Nursing Science
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    • 제24권2호
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    • pp.113-121
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    • 2022
  • Purpose: The purpose of this study was to identify influence of health behavior in patients with coronary artery disease. Methods: A cross-sectional descriptive design included 150 patients treated with percutaneous coronary intervention in S hospital in S city. Data were collected by using self-questionnaires July 5-August 26, 2021 and were analyzed by descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regression with SPSS 23.0. Results: Factors significantly influencing health behavior in patients with coronary artery disease were health empowerment (β = .48, p< .001), and post-traumatic growth (β = .20, p= .013). The explanatory power of related variables was 39%. Conclusion: Based on the this study, it was found that health empowerment and post-traumatic growth had a significant effect on the health behavior of patients with coronary artery disease. Thus, it is necessary to promote the health behavior of patients with coronary artery disease through the development of intervention programs to improve health empowerment and post-traumatic growth.

관상동맥중재술 대상자의 신체적 기능상태, 적대성향, 사회적지지에 관한 연구 (Functional Status, Hostility, and Social Support in Patients with Percutaneous Coronary Intervention)

  • 김지영;김옥수
    • 한국산학기술학회논문지
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    • 제17권8호
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    • pp.226-235
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    • 2016
  • 본 논문은 관상동맥중재술 대상자의 신체적 기능상태, 적대성향, 사회적지지의 관계를 규명하여 간호 중재 개발의 기초자료를 제공하고자 하였다. 서울시 2개 상급종합병원에서 관상동맥중재술을 받고 관리를 위해 외래에 내원한 환자 135명을 대상으로 구조화된 설문지를 이용하여 자료를 수집하였다. 신체적 기능상태는 성별(t=5.880, p<.001), 연령(F=23.620, p<.001), 교육정도(F=17.718, p<.001), 직업(t=-6.498, p<.001), 월수입(F=7.237, p<.001), 흡연여부(t=2.327, p=.025)에 따라 유의한 차이를 보였다. 적대성향은 연령(F=6.150, p=.001), 시술 후 경과기간(F=6.141, p=.001), 가족력(t=2.514, p=.013)에 따라 유의한 차이를 보였다. 사회적지지는 연령(F=2.866, p=.039), 교육정도(F=5.136, p=.002)에 따라 유의한 차이를 보였다. 신체적 기능상태는 사회적지지(r=.20, p=.025), 친구지지(r=.22, p=.010)와 각각 통계적으로 유의한 정적 상관관계가 있었으며, 적대성향(r=-.24, p=.005)과 유의한 부적 상관관계가 있는 것으로 나타났다. 적대성향은 친구지지(r=-.17, p=.046)와 유의한 부적 상관관계가 있었다. 따라서 간호사는 관상동맥중재술 대상자의 특성을 고려하고, 신체적 기능상태, 적대성향, 사회적지지를 향상시킬 수 있는 간호중재 개발할 필요가 있다.

경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석 (Effect of Herbal Medicines on Preventing Restenosis After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 허나연;안수빈;김홍준;장인수
    • 대한한방내과학회지
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    • 제44권3호
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    • pp.387-401
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    • 2023
  • Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

The Prevalence of Cardiovascular Disease Risk Factors and the Framingham Risk Score in Patients Undergoing Percutaneous Intervention Over the Last 17 Years by Gender: Time-trend Analysis From the Mayo Clinic PCI Registry

  • Lee, Moo-Sik;Flammer, Andreas J.;Kim, Hyun-Soo;Hong, Jee-Young;Li, Jing;Lennon, Ryan J.;Lerman, Amir
    • Journal of Preventive Medicine and Public Health
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    • 제47권4호
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    • pp.216-229
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    • 2014
  • Objectives: This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for ${\beta}$-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.

초발 급성 심근경색증 환자의 불확실성과 자가간호 역량 및 생리적 지표 (Uncertainty, Self-care Agency and Physiological Index in Acute Myocardial Infarction Patients who Underwent Primary Percutaneous Coronary Intervention)

  • 조숙희;전경숙
    • 보건의료산업학회지
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    • 제9권4호
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    • pp.105-117
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    • 2015
  • Objectives : The aim of this study was to investigate the relationship among uncertainty, self-care agency and physiological index in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention. Methods : A total of 196 patients who were admitted C National University Hospital from Oct 2014 to Jun 2015 participated in the study. Data were collected with a questionnaire, and the blood pressure, HgA1C, and lipid profile levels of the patients were acquired. Results : The mean age was 69.2 (${\pm}13.0$) years, and 74 % of the patients were men. The mean score for uncertainty in illness was 48.7 (${\pm}8.8$). The mean score for self-care agency was 73.3 (${\pm}13.4$). Self-care agency showed a negative correlation with uncertainty (r=-.579, p<.001), age (r=-.732, p<.001), systolic blood pressure (r=-.265, p=.001) and HgA1C (r=-.293, p<.001). Conclusions : The results of this study can be used to develop a nursing program that prevents AMI and to improve the clinical prognosis of AMI patients.

관상동맥 조영영상에서의 혈관 폭 추출 (Extraction of Vessel Width in Coronary Angiography Images)

  • 김성후;이주원;김주호;최대섭;이건기
    • 한국정보통신학회논문지
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    • 제16권11호
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    • pp.2538-2543
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    • 2012
  • 관상동맥 중재술은 카테터를 통해 협착부위에 스텐트를 삽입하여 치료를 할 수 있는 대표적 검사방법이다. 중재술의 시행에 있어 어려운 점으로는 다양한 스텐트의 종류로 인해 스텐트의 선택에 어려움이 있다. 때문에 협착부위의 혈관 폭을 정확히 측정하여 시술자로 하여금 알맞은 크기의 스텐트를 선택할 수 있도록 도움을 줄 수 있어야 한다. 따라서 본 연구에서는 사용자가 지정한 지점에서 혈관의 중심선을 그린 후, 유클리드 거리 측정법을 이용하여 혈관의 폭을 측정하여 혈관의 폭을 픽셀기반의 프로파일로 나타내었다. 본 실험은 시술자로 하여금 알맞은 크기의 스텐트를 선택할 수 있는 참고자료로 활용될 수 있을 것으로 사료된다.

스텐트 혈전에 의한 재발성 심실성 빈맥을 동반한 급성 심근경색에 경피적 심폐순환보조 (Percutaneous Cardiopulmonary Bypass Support in a Patient with Acute Myocardial Infarction by Stent Thrombosis Complicated with Ventricular Tachycardia)

  • 김상필;이준완
    • Journal of Chest Surgery
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    • 제39권5호
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    • pp.399-402
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    • 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.

The Effects of Exercise-based Cardiac Rehabilitation Phase II on Pro- and Anti-inflammatory Markers in Patients with Acute Coronary Syndrome

  • Kim, Al-Chan;Oh, Jae-Keun;Shin, Kyung-Ah;Kim, Young-Joo
    • 대한의생명과학회지
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    • 제19권1호
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    • pp.61-69
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    • 2013
  • The aim of this study was to evaluate the effect of exercise-based cardiac rehabilitation on pro- and anti-inflammatory markers in patients with acute coronary syndrome (ACS). ACS patients who underwent percutaneous coronary intervention (PCI) and took medicine during phase II of rehabilitation were recruited for study. Subjects were divided into two groups; exercise group (EX, n=21) and a non-exercise group (non-EX, n=13). Supervised exercise program in hospital consisted of treadmill and bicycle exercise was performed three times per week for 6 weeks. Patients of EX received individual counseling, including knowledge of heart disease, risk factor modification, and physical training. Cardiopulmonary fitness, body composition, and biochemical blood factors were analyzed before and after experiment. There was no significant difference in serum levels of hs-CRP and TGF-${\beta}1$ between groups, and between time intervals. But there was a significant decrease in serum levels of IL-18 (P<.001). And there was a significant increase in ratio of IL-18 to IL-10 (P<.01) and serum levels of IL-10 (P<.001). After cardiac rehabilitation, there was significant increase in exercise duration (P<.001), maximal oxygen uptake ($VO_{2peak}$; P<.001) and decrease in submaximal rate-pressure product (sRPP; P<.05) in EX. In conclusion, exercise-based cardiac rehabilitation during phase II in patients with ACS after PCI decreased serum IL-18 (pro-inflammatory) content and ratio of IL-18 to IL-10 in serum (highly related with disease recurrence), and increased serum IL-10 (anti-inflammatory) content. In addition, it led to improved cardiopulmonary fitness.

경피적 관상동맥 중재술을 받은 환자를 대상으로 심장호흡물리치료에 대한 효과 - 체계적 고찰과 메타분석 (Effect of Cardiopulmonary Physiotherapy on Patients With Percutaneous Coronary Intervention - Systematic Review and Meta-Analysis)

  • 강나윤;박범석;김민희
    • 대한물리의학회지
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    • 제14권1호
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    • pp.63-73
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    • 2019
  • PURPOSE: This study examined the effects of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). METHODS: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify studies with randomized and non-randomized controlled trials. As the final outcome, 320 publications were identified and 18 studies met the inclusion and exclusion criteria. All studies were assessed for the quality of study using Cochrane's risk of bias. RESULTS: Sixteen studies met the inclusion criteria, in which meta-analysis had been conducted to examine the effectiveness of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI. Meta-analysis based on a random effect model showed that the cardiopulmonary physiotherapy was beneficial in improving the cardiopulmonary function, metabolism, inflammatory markers, and quality of life. In particular, there was a significant effect on the peak oxygen uptake (effect size 5.30%; 95% confidence interval 3.62~6.97). Cardiopulmonary physiotherapy for a during period of 6 weeks or more was effective in significantly improving the cardiopulmonary function and metabolism function in a subgroup analysis, but cardiopulmonary physiotherapy for less than 6 weeks was not effective. CONCLUSION: Cardiopulmonary physiotherapy has positive effects on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI.