• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.131-134
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• 2023

Here, we present a case of a 56-year-old man with acute myocardial infarction. The patient underwent percutaneous coronary intervention (PCI) at the left main bifurcation and mid-left anterior descending artery using drugeluting stents. Four months after the PCI, the patient was readmitted for cardiac arrest. Coronary angiography (CAG) revealed stent thrombosis in the left main-to-proximal left anterior descending artery and in-stent restenosis in the left main-to-proximal left circumflex artery. We performed balloon angioplasty at the left main to mid-left anterior descending artery and left main to proximal left circumflex artery stents; subsequently, blood flow was fully restored. However, contrast agent extravasation was observed outside the mid-portion of the left main artery to the proximal left anterior descending artery stent, indicating the presence of a coronary artery aneurysm (CAA) outside the stent. After guideline-directed medical therapy with dual antiplatelet agents and high-intensity statins, follow-up CAG revealed near-resolution of the CAA, absence of stenotic lesions, and good blood flow.

• The Korean Journal of Medicine
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• v.93 no.6
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• pp.565-570
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• 2018

Postcardiac injury syndrome (PCIS) is an inflammatory process that usually occurs within 1 to 6 weeks after an injury to the pericardium, epicardium, or myocardium. As more interventions are performed for complicated coronary artery obstructive lesions, there have been some recent reports on PCIS following percutaneous coronary intervention (PCI). The medical management of PCIS depends on nonsteroidal anti-inflammatory drugs (NSAIDs), in addition to colchicine or steroids. An 80-year-old male patient underwent a PCI. Unfortunately, the guidewire piercing failed but he showed no immediate signs of complication. However, 5 hours after the procedure, he complained of chest discomfort. An electrocardiogram showed widespread ST elevation. Chest X-ray and computed tomography showed pulmonary congestion with pleural effusion, while thoracic echocardiography showed a moderate amount of pericardial effusion. NSAIDs were initiated, but there was no improvement of symptoms. We describe an unusual case of atypical earl onset PCIS after PCI, recovered rapidly by steroids.

• 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.

• 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.

• 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.

• Korean Circulation Journal
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• v.54 no.9
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• pp.519-533
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• 2024

The outstanding development in contemporary medicine, highlighted by percutaneous coronary intervention (PCI), was achieved through the adoption of drug-eluting stents (DESs). Although DES is the established therapy for patients undergoing PCI for de novo coronary artery disease (CAD), their drawbacks include restenosis, stent thrombosis, and the requirement for dual antiplatelet therapy (DAPT) with an uncertain duration regarding its optimality. Drug-coated balloon (DCB) treatment leaves nothing behind on the vessel wall, providing the benefit of avoiding stent thrombosis and not necessitating obligatory extended DAPT. After optimizing coronary blood flow, DCB treatment delivers an anti-proliferative drug directly coated on a balloon. Although more evidence is needed for the application of DCB treatment in de novo coronary lesions, recent studies suggest the safety and effectiveness of DCB treatment for diverse conditions including small and large vessel diseases, complex lesions like bifurcation lesions or diffuse or multivessel diseases, chronic total occlusion lesions, acute myocardial infarctions, patients at high risk of bleeding, and beyond. Consequently, we will review the current therapeutic choices for managing de novo CAD using DCB and assess the evidence supporting their concurrent application. Additionally, it aims to discuss future important perspectives.

• 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.

• 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.

• 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.

• 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.