• Title/Summary/Keyword: Stenosis of coronary artery

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Assessment of Coronary Stenosis Using Coronary CT Angiography in Patients with High Calcium Scores: Current Limitations and Future Perspectives (높은 칼슘 점수를 가진 환자에서 관상동맥 CT 조영술을 이용한 협착 평가의 한계와 전망)

  • Doo Kyoung Kang
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.270-296
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    • 2024
  • Coronary CT angiography (CCTA) is recognized for its role as a gatekeeper for invasive coronary angiography in patients suspected of coronary artery disease because it can detect significant coronary stenosis with high accuracy. However, heavy plaque in the coronary artery makes it difficult to visualize the lumen, which can lead to errors in the interpretation of the CCTA results. This is primarily due to the limited spatial resolution of CT scanners, resulting in blooming artifacts caused by calcium. However, coronary stenosis with high calcium scores often requires evaluation using CCTA. Technological methods to overcome these limitations include the introduction of high-resolution CT scanners, the development of reconstruction techniques, and the subtraction technique. Methods to improve reading ability, such as the setting of appropriate window width and height, and evaluation of the position of calcified plaque and residual visibility of the lumen in cross-sectional images, are also recommended.

Analysis of the Influential Factors for Metabolic Syndrome on Stenosis after Coronary Angiography (심장동맥조영술 후 협착에 미치는 대사증후군의 영향인자 분석)

  • Kim, Gyu-Hee;Ji, Tae-Jeong
    • Journal of radiological science and technology
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    • v.45 no.1
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    • pp.19-29
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    • 2022
  • The study is conducted with the subjects who have under gone coronary angiography to examine the influential factors for the severity of coronary stenosis. Four indicators related to hypertension, diabetes, dyslipidemia, obesity of metabolic syndrome were used as influential factors. As a result of the study, metabolic syndrome such as diabetes and dyslipidemia had 3.3 times and 7.7 times higher chance to lead to 1VD, respectively. In 2VD, diabetes showed 2.9 times higher risk, and dyslipidemia showed 8.5 times higher risk. In 3VD, diabetes was found to be 5 times higher and dyslipidemia was 17.5 times higher in risk. Therefore, it was confirmed that dyslipidemia showed the highest correlation among metabolic syndromes. According to this study, it was confirmed that dyslipidemia and diabetes were closely related to the influential factors for coronary artery stenosis.

Onlay Patch Coronary Angioplasty with Autologous Saphenous Vein (자가정맥편을 이용한 관상동맥 혈관성혈술)

  • 류경민;김삼현;박성식;류재옥;서필원
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.512-517
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    • 2000
  • Background: Onlay vein patch coronary angioplasty has been known to be an option for coronary artery stenosis in the selective iesions Material and method: During the period between July 1997 and August 1999, coronary angioplasty using autologous saphenous vein was done on 16 sites in 14 cases for the stenotic lesion at the bifurcation area and significantly stenosis distal to anastomosis. Result: Early patency of the angioplasty site was 85.7% at postoperative day 7. There was no statistically difference in graft patency, operative parameters, and complications compared to conventional anatomosis(p>0.05). Conclusion: Despite the small number of cases, the patency rate of the coronary patch angioplasty was comparable to the conventional CABG. Coronary artery only patch angioplasty could be performed in highly selected coronary arteries.

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Angioplasty of Isolated Left Ostial Coronary Artery Tenosis in a Patient with Takayaus's Aortitis (Takayasus씨 대동맥염에 의한 단순 좌관상동맥 개구부협착의 성형술)

  • 안병희
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.170-173
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    • 1994
  • Isolated stenotic lesion located at the ostium of the left main coronary artery associated with Takayasu`s aortitis is quite rare. This report herein described a case of 25 year old woman with isolated ostial stenosis of the left main coronary artery underwent pericardial patch [fixed with 0.6 % glutaraldehyde] angioplasty. An anterior approach was used and postoperative coronary angiogram of the patient showed normal coronary ostial contour with normal runoff.

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A Hybrid Procedure for Coronary Artery Disease with Left Subclavian Artery Stenosis (쇄골하 동맥협착이 동반된 관상동맥질환 환자에서의 하이브리드 술식)

  • Chang, Yong-Jin;Lee, Jae-Won;Jung, Sung-Ho;Je, Hyoung-Gon
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.252-255
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    • 2009
  • We performed a hybrid procedure for a 58-year-old man with coronary artery disease and a left subclavian artery stenosis. He underwent left subclavian artery stenting and off-pump coronary artery bypass surgery, including grafting the in situ left internal mammary artery to the left anterior descending coronary artery. The post-operative coronary angiogram and computed tomography showed good patency of the graft and stent. He discharged at postoperative 8 days and he has been followed up for six month with an excellent clinical condition.

Coronary Arteriovenous Fistula Associated with Aortic Stenosis and Regurgitation -Report of a Case (대동맥판협착 및 폐쇄부전증을 동반한 관상동정맥루 -1례 치험-)

  • 조창훈
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1133-1137
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    • 1991
  • Congenital coronary arteriovenous fistula is relatively uncommon and often associated with additional congenital and acquired heart disease. If coronary arteriovenous fistula is suspected, the diagnosis can be made readily by cardiac catheterization and selective coronary arteriography. Surgical treatment is very satisfactory, with a low mortality and apparent good long term result. Recently, we experienced one case of congenital coronary arteriovenous fistula which was associated with aortic stenosis and regurgitation. The tortuous fistula tract was noted between the left anterior descending coronary artery and the main pulmonary artery. Under the cardiopulmonary bypass, aortic valve replacement[Carbomedics 23mm] and suture closure of the draining orifice of coronary arteriovenous fistula in the main pulmonary artery just above the pulmonary valve were performed, Postoperative hospital course was uneventful and the patient was discharged postoperative 9th day without any problems.

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Coronary Artery Stenosis Quantification for Computed Tomography Angiography Based on Modified Student's t-Mixture Model

  • Sun, Qiaoyu;Yang, Guanyu;Shu, Huazhong;Shi, Daming
    • ETRI Journal
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    • v.39 no.5
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    • pp.662-671
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    • 2017
  • Coronary artery disease (CAD) is a major cause of death in the world. As a non-invasive imaging modality, computed tomography angiography (CTA) is now usually used in clinical practice for CAD diagnosis. Precise quantification of coronary stenosis is of great interest for diagnosis and treatment planning. In this paper, a novel cluster method based on a Modified Student's t-Mixture Model is applied to separate the region of vessel lumen from other tissues. Then, the area of the vessel lumen in each slice is computed and the estimated value of it is fitted with a curve. Finally, the location and the level of the most stenoses are captured by comparing the calculated and fitted areas of the vessel. The proposed method has been applied to 17 clinical CTA datasets and the results have been compared with reference standard degrees of stenosis defined by an expert. The results of the experiment indicate that the proposed method can accurately quantify the stenosis of the coronary artery in CTA.

Aortic Valve Replacement for Aortic Stenosis and Concomitant Coronary Artery Bypass: Long-term Outcomes and Predictors of Mortality

  • Cho, Won-Chul;Yoo, Dong-Gon;Kim, Joon-Bum;Lee, Jae-Won;Choo, Suk-Jung;Jung, Sung-Ho;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.131-136
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    • 2011
  • Background: We evaluated the surgical results and predictors of long-term survival in patients who underwent coronary artery bypass grafting (CABG) at the time of an aortic valve replacement (AVR) due to aortic stenosis. Materials and Methods: Between January 1990 and December 2009, 183 consecutive patients underwent CABG and concomitant aortic valve replacement for aortic stenosis. The mean follow-up period was $59.8{\pm}3.3$ months and follow-up was possible in 98.3% of cases. Predictors of mortality were determined by Cox regression analysis. Results: There were 5 (2.7%) in-hospital deaths. Follow-up of the in-hospital survivors documented late survival rates of 91.5%, 74.8%, and 59.6% at 1, 5, and 10 postoperative years, respectively. Age (p<0.001), a glomerular filtration rate (GFR) less than 60 mL/min (p=0.006), and left ventricular (LV) mass (p<0.001) were significant predictors of mortality in the multivariate analysis. Conclusion: The surgical results and long-term survival of aortic valve replacement with concomitant CABG in patients with aortic stenosis and coronary artery disease were acceptable. Age, a GFR less than 60 mL/min, and LV mass were significant predictors of mortality.

Coronary Artery Bypass Grafting Using Sequential Graft of the Left Internal Mammary Artery (내유동맥 연쇄문합술을 이용한 관동맥우회로 이식술)

  • 오상기
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.167-172
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    • 2000
  • Background: As the internal mammary artery is far superior to the vein in the patency rate recently there has been a tendency to use the arterial graft as much as possible in coronary artery bypass grafts with the expectation of better the short- and long-term patency rate. Material and Method: We sequentially grafted the diagonal and the left anterior descending artery significantly influencing the cardiac function with the internal mammary artery. There were 32 cases of sequential grafts from July 1993 to December 1998: 21 men and 11 women. The age range was from 43 to 69 years with a mean age of 56.64$\pm$6.41 years. There were 22 unstable angina 7 stable angina and 3 acute myocardial infarction. 8 cases of them were accompanied by stenosis of the left main coronary artery. The grafts for coronary artery bypass surgery included the great saphenous vein at 60 the right gastroepiploci artery at 5 and the left internal mammary artery at 64 coronary arteries. Result: One patient died from sepsis and multiorgan failure. Complications included wound infections in two cases and gastrointestinal bleeding in one patient. All patients showed decrease or disappearance of angina after operation. The postoperative coronary angiogram performed in 9 patients showed neither occlusion nor stenosis of the grafts. Conclusion: This study suggests that sequential anastomosis of the internal mammary artery to the diagonal and the left anterior descending artery may result in excellent short-term patency diagonal and the left anterior descending artery may result in excellent short-term patency rate and be useful for the coronary artery bypass graft using only arterial grafts

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Comparison of Blooming Artifact Reduction Using Image Segmentation Method in CT Image (CT영상에서 이미지 분할기법을 적용한 Blooming Artifact Reduction 비교 연구)

  • Kim, Jung-Hun;Park, Ji-Eun;Park, Yu-Jin;Ji, In-Hee;Lee, Jong-Min;Cho, Jin-Ho
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.295-301
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    • 2017
  • In this study, We subtracted the calcification blooming artifact from MDCT images of coronary atherosclerosis patients and verified their accuracy and usefulness. We performed coronary artery calcification stenosis phantom and a program to subtract calcification blooming artifact by applying 8 different image segmentation method (Otsu, Sobel, Prewitt, Canny, DoG, Region Growing, Gaussian+K-mean clustering, Otsu+DoG). As a result, In the coronary artery calcification stenosis phantom with the lumen region 5 mm the calcification blooming artifact was subtracted in the application of the mixture of Gaussian filtering and K- Clustering algorithm, and the value was close to the actual calcification region. These results may help to accurately diagnose coronary artery calcification stenosis.