• Title/Summary/Keyword: Percutaneous Coronary Intervention (PCI)

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Multi-vessel intractable coronary spasm development in a patient with aborted sudden cardiac death: a case study with intravascular ultrasound findings

  • Cho, Sungsoo;Kang, Tae Soo
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.121-126
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    • 2018
  • Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.

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.

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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    • v.47 no.4
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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.

Clinical Effectiveness of Acupuncture Related to Improvement in Quality of Life and Problems after Percutaneous Coronary Intervention : A Systematic Review (관상동맥 중재술 후 문제점 및 삶의 질 개선에 관한 침 치료 효과 : 체계적 문헌 고찰)

  • Lee, Ji Sung;Park, Ui Hyun;Kwon, Jung-nam
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.33 no.2
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    • pp.82-88
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    • 2019
  • This systematic review evaluates the clinical effectiveness of acupuncture related to improvement in quality of life and problems after Percutaneous Coronary Intervention(PCI). We searched papers in many databases, including National Discovery for Science Leaders(NDSL), Koreanstudies Information Service System(KISS), Oriental Medicine Advanced Searching Integrated System(OASIS), Research Information Sharing Service(RISS), Public/Publisher MEDLINE(Pubmed), Embase, Cochranelibrary, Chinese Academic Journals(CAJ), Japan Science and Technology Agency(J-STAGE). Initially, 161 studies were found. Of these, 141 studies were excluded following abstract screening. After the remaining 20 papers were scanned, 5 RCTs were selected and analyzed. Among these 5 RCTs, HAMD(Hamilton Rating Scale for Depression) is significantly effective in 1 RCT. In 2 RCTs, LVEF(Left Ventricular Ejection Fraction) is significantly effective. In 2 RCTs, 6MWT(Six-Minute Walk Test) is significantly effective. The review of 5 studies suggests that acupuncture after PCI can be effective in many problems occured after PCI. However, This study couldn't conduct a meta-analysis due to the differences in interventions. Therefore, we hope that systematic reviews with meta-analysis will be published.

Comparison of Vessel Elasticity according to Risk Factors for Coronary Artery Disease, and the Mediating Effects of Treatment Compliance among Patients with Percutaneous Coronary Intervention (관상동맥질환 위험정도와 혈관탄성의 관계에서 치료지시이행의 매개효과: 경피적 관상동맥 중재술 환자 대상)

  • Yeo, Ga Ram;Sung, Kyung Mi
    • Journal of East-West Nursing Research
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    • v.22 no.1
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    • pp.32-40
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    • 2016
  • Purpose: This study aimed to provide basic data for vascular health of patient who underwent percutaneous coronary intervention (PCI) by verifying the mediating effect of compliance in the relationship between risk level of coronary artery disease (CAD) and blood vessel elasticity. Methods: This is a descriptive study with 115 patients, who underwent the PCI a year ago and visited in the cardiology department from January to March, 2015. The risk level of CAD, blood vessel elasticity and the compliance were measured. For data analysis, SPSS/WIN 21.0 and AMOS (IBM) 21.0 were used. Results: There were a positive correlation with blood vessel elasticity score (i.e. inelasticity of the blood vessel wall) (r=.189) and a negative correlation with compliance (r=-.658) in mediating effect of risk level of CAD. There was a negative correlation between compliance and blood vessel elasticity (r=-.482). The direct effect (${\beta}=-.226$), indirect effect (${\beta}=.415$) and total effect (${\beta}=.186$) of mediating effect of risk level of CAD on blood vessel elasticity were significant. Compliance had a partial mediating effect of risk level of CAD on blood vessel elasticity. Conclusion: The results of this study suggest that managing and preventing moderating effect of risk level of CAD on compliance is helpful in restoring blood vessel elasticity.

A Study of Diagnostic Reference Levels for Coronary Angiography and Percutaneous Coronary Intervention in Gyeongsang Area (관상동맥 조영술 및 경피적 관상동맥 중재술에 대한 진단참고준위에 관한 연구; 경상도지역중심)

  • Si-Wang Lim;Jung-Su Kim;Pyong-Kon Cho
    • Journal of radiological science and technology
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    • v.46 no.2
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    • pp.123-129
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    • 2023
  • Interventional cardiology procedures can involve relatively high radiation doses compared to conventional radiography. During CAG, CAG + PCI and PCI the same area is exposed to radiation for a long period. In this study, radiation exposure data of 421 examinations in Gyeongsang area were collected, and the DRLs and ADs in actual medical practice for three types of interventional cardiology procedures in Korea were established. In CAG 286 case, 75th percentile DRLs and ADs of the total DAP were 55.89 Gy·cm2 and 37.47 Gy·cm2 , respectively. In CAG + PCI 92 case, those values were 222.84 Gy·cm2 and 117.51 Gy·cm2 respectively. In PCI 43 case, those values were 198.73 Gy·cm2 and 120.13 Gy·cm2 respectively. In this study, for the first time, the diagnostic reference level of interventional cardiology procedures in Gyeongsang area were established. Using the diagnostic reference level of interventional cardiology procedures derived from this study, it will help to identify and improve the level of exposure dose in the region and country.

Beta Blockers or Calcium Channel Blockers as Primary Antianginal Drug after Percutaneous Coronary Intervention: Prescription Pattern and its association with Clinical Outcome (관상동맥중재술 전후 주요 항협심증 약제로서의 베타차단제와 칼슘채널차단제: 처방패턴 및 임상결과에 미치는 영향)

  • Noh, Sun Young;Jo, Yun Hee;Cho, Yoon Sook;Hahn, Hyeon Joo;Lee, Hae-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.213-219
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    • 2016
  • Objective: Although guideline recommends beta blockers (BBs) as first line antianginal agent and calcium channel blockers (CCBs) as alternatives after percutaneous coronary intervention (PCI), the prescription patterns in real practice are not in accordance with the guideline. We aimed to investigate the prescribing patterns of primary antianginal drug and relating factors in patients who underwent PCI. Methods: Patients who have undergone PCI without myocardial infarction (MI) from November 2012 to June 2014 and followed up at least one year in a tertiary teaching hospital were included. Prescribing patterns of primary antianginal drug before, at the time of, and one year after PCI were described. Factors affecting drug selection, and their relationship with incidence of clinical outcomes defined as MI and repeated PCI, unscheduled admission or visit related with heart problem were analyzed with multivariate logistic regression. Results: A total of 506 patients were included and as primary antianginal drugs, BB, CCB, and both were prescribed in 32.2%, 24.5%, and 17.8% of patients, respectively. Also, neither BB nor CCB was prescribed at the time of PCI in 25.5% of patients. Compared with BB, CCBs were more likely prescribed in patients who had hypertension (Odds Ratio, OR 2.18, 95% confidence interval, CI 1.16-4.07), use of same class before PCI (OR 7.18, 3.37-15.2) and concomitant angiotensin receptor blocker (ARB) use (OR, 1.92, 95% CI 1.10-3.33). Incidence of clinical outcomes were not significantly greater in patients who prescribed CCB compared with BB at the time of PCI (aOR 1.32, CI 0.65-2.68). Conclusion: This study demonstrated that half of the patients who underwent PCI were prescribed BB. CCB were favored in patients with hypertension, use of same class before PCI, and concomitant ARB use. Significant difference in clinical outcome was not observed between BB and CCB selection as primary antianginal drug.

CT Angiography-Derived RECHARGE Score Predicts Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

  • Jiahui Li;Rui Wang;Christian Tesche;U. Joseph Schoepf;Jonathan T. Pannell;Yi He;Rongchong Huang;Yalei Chen;Jianan Li;Xiantao Song
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.697-705
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    • 2021
  • Objective: To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGECCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Materials and Methods: One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGECCTA scores were calculated and compared with RECHARGECA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores. Results: The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGECCTA score and the RECHARGECA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGECCTA score was higher than the RECHARGECA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGECCTA and RECHARGECA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGECCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGECCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665-0.717, all p > 0.05). Conclusion: The non-invasive RECHARGECCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGECCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

Radiation Dose and Estimate of Lifetime Attributable Risk of Cancer from Coronary Angiography and Percutaneous Coronary Intervention (관상동맥조영술과 경피적관상동맥중재술에서 환자 선량과 암 발생 생애귀속위험 평가)

  • Kang, Yeong-Han;Kim, Bu-Sun;Park, Jong-Sam
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.213-221
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    • 2010
  • The Purpose of this study was to determine the effective dose to an average patient from Coronary Angiography (CA) and Percutaneous Coronary Intervention (PCI). And to estimate the lifetime attributable risk (LAR) of cancer associated with radiation exposure from CA and PCI. The dose-area product (DAP) values to the patient were recorded from 60 CA and 58 PCI. A Monte Carlo based program PCXMC was used to calculate the effective dose from DAP values for each patient. Lifetime attributable risks were estimated with models developed in the National Academies' Biological Effects of Ionizing Radiation VII report. The mean DAP values was $53.76\;Gy{\cdot}cm^2$ for CA and $165.82\;Gy{\cdot}cm^2$ for PCI. Mean effective dose were 1.28 mSv in CA, 3.94 mSv in PCI. Results of Calculate organ dose, lung doses was 2.17 mSv in CA and 6.71 mSv in PCI. Female breast doses was 5.45 mSv in CA and 16.82 mSv in PCI. LAR estimates for CA varied from 1 in 1,508 for man to 1 in 1,357 for women. In PCI procedure varied from 1 in 553 for man to 1 in 482 for women. DAP can be used as the dose indicator to calculate the organ dose and effective dose of patient based on Monte Carlo simulation. These dose estimates derived from our simulation models suggest that CA and PCI are associated with a nonnegligible LAR of cancer. This risk varies markedly and is considerably greater for women, PCI than for man, CA.

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

  • Kang, Na-yoon;Park, Beom-seok;Kim, Min-hee
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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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.