• 제목/요약/키워드: Stenosis of coronary artery

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2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT)

  • Cherry Kim;Chul Hwan Park;Bae Young Lee;Chan Ho Park;Eun-Ju Kang;Hyun Jung Koo;Kakuya Kitagawa;Min Jae Cha;Rungroj Krittayaphong;Sang Il Choi;Hwan Seok Yong;Sung Min Ko;Sung Mok Kim;Sung Ho Hwang;Nguyen Ngoc Trang;Whal Lee;Young Jin Kim;Jongmin Lee;Dong Hyun Yang
    • Korean Journal of Radiology
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    • 제25권4호
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    • pp.331-342
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    • 2024
  • The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

관상동맥 협착부에 각이진 스텐트 시술시 혈류역학적 특성변화 (Changes of Hemodynamic Characteristics during Angulated Stenting in the Stenosed Coronary)

  • 서상호;조민태;권혁문;이병권
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2002년도 학술대회지
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    • pp.717-720
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    • 2002
  • The present study is to evaluate the performances of flow velocity and wall shear stress in the stenosed coronary artery using human in vivo hemodynamic Parameters and computer simulation. Initial and follow-up coronary angiographics in the patients with angulated coronary stenosis are performed. Follow-up coronary angiogram demonstrated significant difference in the percent of diameter in the stenosed coronary between two groups ($Group\;1:\;40.3{\%},\;Group\;2:\;25.5{\%}$). Flow-velocity wave obtained from in vivo intracoronary Doppler ultrasound data is used for the boundary condition for the computer simulation. Spatial and temporal variations of flow velocity vector and recirculation area are drawn throughout the selected segment of coronary models. The WSS of pre- and post-intracoronary stenting are calculated from three-dimensional computer simulation. Then negative shear stresses area on 3D simulation we noted on the inner wall of the post-stenotic area before stenting. The negative WSS is disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2. The present study suggest that hemodynamic forces exerted by pulsatile coronary circulation termed WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. The local recirculation area which has low or negative WSS, might lead to progression of atherosclerosis.

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관상동맥의 기하학적 형상변화에 따른 동맥경화 위험도 (Atherogenic Risk Stratification According to Changes in the Geometrical Shape of the Coronary Artery)

  • 서상호;박준길;노형운;이병권;권혁문
    • 대한기계학회논문집B
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    • 제34권10호
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    • pp.893-899
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    • 2010
  • 박동유동조건에서 관상동맥 내의 유동특성과 혈류역학적 인자 분포를 선행연구에서 수행하여 혈류역학이 관상동맥 내의 협착현상과 연관관계가 있음을 밝혔다. 동맥경화증의 호발부위인 관상동맥 분지부에서 혈류역학적 변수를 분석하여 동맥경화증의 발생기전을 규명하는 것이 본 연구의 목적이다. 동맥경화증에 의한 협착현상은 혈액과 혈관벽 사이의 생화학 반응뿐 아니라 유동박리나 벽전단응력과 같은 혈류역학적 인자와도 관계 있음을 확인하였다. 관상동맥 분지부의 분지각이 증가할수록 분지부 단면에서의 재순환영역의 크기가 증가하고 교란유동이 발생하게 된다. 이 재순환영역이 관상동맥에서 동맥경화의 시작점으로 의심되는 영역이라 할 수 있다.

CCTA를 이용한 관상동맥 협착과 석회화의 상관관계 분석 (Correlation Analysis Between Stenosis and Calcification of Coronary Artery with Using CCTA)

  • 김상진
    • 대한방사선기술학회지:방사선기술과학
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    • 제32권4호
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    • pp.427-435
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    • 2009
  • 본 연구는 관상동맥질환의 위험인자 중 성별, 연령별 협착률과 혈관 협착과 석회화와의 상관관계를 분석하기 위해 조사대상병원에서 조사 기간 동안 CCTA를 시행한 대상자 586명의 관상동맥의 협착률과 석회화의 유무를 조사하였다. 전체 대상자 중 협착이 있는 사람은 299명으로 이 중 남성 166명(28%), 여성 133명(23%)이었다. 50~70대가 협착이 있는 자의 246명(82.6%)으로 대부분을 차지하였다. 1개의 혈관이상에서 협착률이 50%가 넘는 협착이 있는 자는 299명 중 남성은 60대에서 43명(33.9%), 여성은 70대에서 39명(37.5%)으로 나타났다. Vessel score가 2점 이상 되는 경우가 70% 이상 협착이 있는 자 139명 중에 70명(50.1%)이었고 남성은 60대가 32명(39.5%), 여성은 70대가 27명(46.6%)으로 나타났다. 특징적인 것은 70대에서 Vessel score가 3점이 되는 경우가 14명으로 다른 연령대보다 2~5배까지 많은 결과를 볼 수 있었다. LAD가 77.6%, LCX가 47.5%, RCA가 60.5%의 협착 빈도를 나타내었고 삼중혈관병변(Triple vessel disease)은 남성이 15명(36.6%), 여성이 13명(56.5%)으로 남녀 모두 70대에서 가장 높은 빈도를 나타내었다. 협착이 있는 그룹에서는 196명 (33.4%)이 석회화가 있었고, 관상동맥 협착이 없는 그룹에서는 40명(6.8%)만이 석회화가 있었다. 이것은 관상동맥의 협착에 석회화가 절대적인 영향을 미친다고는 볼 수 없지만, 상당히 연관성이 있다고 할 수 있겠다.

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복재정맥을 이용한 관상동맥 우회로 수술 - 12례 보고 - (Aortocoronary Saphenous Vein Bypass in Coronary Artery Occlusive Disease)

  • 곽문섭
    • Journal of Chest Surgery
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    • 제23권1호
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    • pp.61-72
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    • 1990
  • From Nov. 1987 to Aug. 1989, 12 patients with coronary occlusive disease underwent coronary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College. The results were as follows: 1. There were 9 males and 3 females ranged in age from 25 to 69 years with a mean of 50.4 years. 2. The prevalent locations of coronary artery stenosis were left anterior descending branch [9 cases], right coronary artery[4 cases], first diagonal branch[3 cases], left circumflex artery [2 cases] in order of frequency. 3, Among 12 cases, 5 cases had an episode of previous myocardial infarction respectively. 4. We performed triple bypass operation in 3 cases, double bypass in 2 cases and single bypass in 7 cases using great saphenous vein. 5. Postoperative complications were cerebral embolism[1, died], pleural effusion[1], temporary cardiac arrest[1], supraventricular tachycardia[1] and late gastric ulcer bleeding[1]. 6. The follow up periods were ranged from 8 months to 30 months and all survivors were on antiplatelet medication showing free of angina.

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좌관상동맥 입구협착의 외과적 확장술 (Surgical Angioplasty of Isolated Left Coronary Ostial Stenosis)

  • 서필원
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.247-252
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    • 1995
  • The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.

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관상동맥질환에서 심장 하이브리드 영상의 임상적 이용 (Clinical Application of Cardiac Hybrid Imaging in Coronary Artery Disease)

  • 조인호;공은정
    • Journal of Yeungnam Medical Science
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    • 제26권1호
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    • pp.15-23
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    • 2009
  • Constant technological developments in coronary artery disease have contributed to the assessment of both the presence of coronary stenosis and its hemodynamic consequences. Hence, noninvasive imaging helps guide therapeutic decisions by providing complementary information on coronary morphology and on myocardial perfusion and metabolism. This can he done using single photon emission computed tomography (SPECT) or positron emission tomography (PET) and multidetector CT (MDCT). Advances in image-processing software and the advent of SPECT/CT and PET/CT have paved the way for the combination of image datasets from different modalities, giving rise to hybrid imaging. Three dimensional cardiac hybrid imaging helped to confirm hemodynamic significance in many lesions, add new lesions such as left main coronay artery disease, exclude equivocal defects, correct the corresponding arteries to their allocated defects and identify culprit segment. Cardiac hybrid imaging avoids the mental integration of functional and morphologic images and facilitates a comprehensive interpretation of coronaty lesions and their pathophysiologic adequacy by three dimensional display of fused images, and allows the best evaluation of myocardial territories and the coronary-artery branches that serve each territory. This integration of functional and morphological information were feasible to intuitively convincing and might facilitate development of a comprehensive non-invasive assessment of coronary artery disease.

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불안정 협심증의 외과적 치험;11례 보고 (Surgical Treatment of Unstable Angina; a Report of 11 Cases)

  • 최필조
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.349-354
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    • 1993
  • From July 1992 through January 1993, 11 patients with unstable angina received aorto-coronary bypass surgery at Dong-A University Hospital. There were 5 males and 6 females whose age ranged from 36 to 76 years old. Of the 11 patients, 3 were Functional class IL 5 were Functional class 111.3 were Functional class IV. Preoperative coronary angiography showed a significant stenosis of the left anterior descending artery in 9 cases, of its diagonal branch in I case, of the circumfiex artery in 3 cases, and of its obtuse marginal branch in 2 cases, of the right coronary artery in 4 cases, and of left main coronary artery in 3 cases. There were 4 cases of single vessel disease, 1 double vessel disease, 3 triple vessel disease and 3 left main disease. A single graft was placed in 1 patient, a double graft in 5, a triple graft in 2, and a quadriple graft in 3 patients. Left internal mammary artery plus saphenous vein graft were used in 4 patients. Postoperative complications were mediastinitis in 1, sternal instability in 2, pneumonia in 1, arrythmia in I case.

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