• Title/Summary/Keyword: percutaneous

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The Development and Effects of an Integrated Symptom Management Program for Prevention of Recurrent Cardiac Events after Percutaneous Coronary Intervention (관상동맥 중재술 후 심질환 재발장지를 위한 통합적 증상관리 프로그램의 개발 및 효과검증)

  • Son, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.38 no.2
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    • pp.217-228
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    • 2008
  • Purpose: This study was conducted to develop and to determine the effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention. Methods: Subjects consisted of 58 CAD patients (experimental group: 30, control group: 28). The experimental group participated in an integrated symptom management program for 6 months which was composed of tailored education, stress management, exercise, diet, deep breathing, music therapy, periodical telephone monitoring and a daily log. The control group received the usual care. Results: The experimental group significantly decreased symptom experiences and the level of LDL compared to the control group. The experimental group significantly increased self care activity and quality of life compared to the control group. Although no significant difference was found in cardiac recurrence, the experimental group had fewer recurrences. Conclusion: These results suggest that an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention can improve symptom aggravation, recurrent rate, self care activity and quality of life. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented in the overall transition period.

The Effects of Hand Massage in Patients Who Underwent Transradial Percutaneous Coronary Intervention (요골동맥을 통한 경피적 관상동맥 중재술 환자의 손마사지 효과)

  • Shin, Eun Sil;Kim, Myung-Hee
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.465-474
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    • 2018
  • Purpose: This study aimed to determine the effect of hand massage in patients who underwent transradial percutaneous coronary intervention. Methods: This was a quasi-experimental study with a nonequivalent control group and non-synchronized design. The study included 30 patients in the experimental group and 30 in the control group. Hand massage was performed 2 times for 5 minutes each in the experimental group and the control group only received usual nursing interventions. Pain, level of discomfort, and vital signs were defined as key outcome measures, and the data were analyzed using the chi-square test, an independent t-test, Mann-Whitney U test, repeated-measures analysis of variance, and Friedman test. Results: Significant differences were observed between the 2 groups in the pain score (F=7.91, p=.003), discomfort score (F=18.15, p<.001), pulse (F=12.92, p<.001), and respiration rate (${\times}^2=19.35$, p<.001). Conclusion: Hand massage can be a helpful nursing intervention for transradial percutaneous coronary intervention by reducing pain and discomfort to a considerable degree.

Effects of Spousal Support and Self-efficacy on Adherent Behavior among Patients with Percutaneous Coronary Intervention (관상동맥중재술을 받은 환자의 배우자지지와 자기효능감이 건강행위 이행에 미치는 영향)

  • Hwang, Hyun-Ju;Lee, Eun-Nam
    • Journal of Korean Critical Care Nursing
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    • v.5 no.1
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    • pp.34-43
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    • 2012
  • Purpose: This study is a descriptive correlational study to examine the effects of spousal supports and self-efficacy on adherent behavior and to describe nursing intervention programs for patients with percutaneous coronary intervention. Methods: The subjects for this study were 120 patients treated with percutaneous coronary intervention in H hospital in B city > 6 months. The data was collected from June 1 to September 30, 2010. Spousal supports were measured by the Family Support questionnaire. Self-efficacy was measured by revised Self Efficacy questionnaire. Adherent behavior was measured by revised Adherence Behavior questionnaire. Results: A multiple regression analysis showed that the most significant predictor of adherent behavior was self-efficacy, followed by spousal support, whether the subjects do regular exercise and the type of diagnosis. Conclusion: Findings suggest that intervention focusing on self-efficacy and spousal support will be needed to improve the adherent behavior among patients with percutaneous coronary intervention.

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Severe Complication of Percutaneous Dilatational Tracheostomy (경피적 확장 기관 절개술의 중대 합병증)

  • Cho, Young-Jin;Lim, Ji-Hyung;Lee, Yong-Joo;Nam, Inn-Chul
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.54-57
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    • 2016
  • Percutaneous dilatational tracheostomy (PDT) has become an increasingly popular method of establishing an airway for patients in need of chronic ventilator assistance. We report a rare case of a 42-year-old female who developed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum after percutaneous dilatational tracheostomy. The patient suffered from amyotrophic lateral sclerosis, and underwent PDT after a period of mechanical ventilation. During PDT, tracheostomy tube was inserted into the paratracheal space. Follow-up chest radiography and computed tomography of chest and abdomen revealed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum. The patient was treated successfully with insertion of the thoracostomy tube and conservative care.

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Percutaneous Treatment with Steroid Injections and Distension of Facet Synovial Cyst -A case report- (요추 추간관절 활액낭의 경피적 치료 증례 -증례 보고-)

  • Lee, Seuk Jin;Kim, Young Ki;Jung, Hwa Sung;Lim, Jong Bum;Lee, Chung
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.246-250
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    • 2005
  • Facet joint synovial cysts are uncommon intraspinal abnormalities, which appear to be secondary to degenerative changes of the joints. They can cause chronic back pain and radiculopathy, as shown in spinal stenosis. When symptomatic cysts fail to respond to conservative measurements, surgical decompression is known as the standard treatment. Percutaneous steroid injections, and distension of the cysts under fluoroscopic guidance, may be a minimally invasive treatment option. Here, the case of a patient with a symptomatic L5-S1 facet joint synovial cyst and left S1 radiculopathy, who responded satisfactorily to percutaneous treatment, is presented.

Raiofrequency Neurotomy for Lumbar Facet Joint Pain in the Patients with Failed Back Surgery Syndrome (척추수술 후 증후군 환자에서 관찰된 추간관절통에 대한 고주파신경절리술)

  • Lee, Jeong Hoon;Shim, Jae Chol
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.151-155
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    • 2005
  • Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.

Percutaneous Sacroplasty for the Sacral Insufficiency Fracture Caused by Metastasis (척추 전이암에 의한 천추 압박골절의 경피적 천추성형술 -증례보고-)

  • Kwon, Won Il;Han, Kyung Ream;Kim, Chan;Joo, Eun Jin
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.229-232
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    • 2008
  • Insufficiency fractures of the sacrum are relatively common and cause severe low back and buttock pain. Percutaneous vertebroplasty is effective for treating vertebral compression fractures. We present a case of percutaneous sacroplasty for the treatment of low back and buttock pain in a sacral insufficiency fracture. A 79-year-old male with non-small lung cancer presented with severe low back and buttock pain after series of radiation treatments. Preoperative MRI showed both a sacral ala and S2 metastatic insufficiency fracture. An epidural port was inserted for continuous morphine infusion and sacral nerve root blocks were performed. However, his pain did not diminish and we attempted percutaneous sacroplasty. Both sides of the sacroplasty were done with a fluoroscopy-guided technique with 1.7 ml and 2.3 ml of bone cement injected into the right and left sacral ala. Pain relief was significant and the patient was able to sit down 1 day after the procedure.

Guide wire fracture during percutaneous coronary intervention (경피적 관상동맥 확장 성형술 도중 우관상동맥 뒤가쪽가지에서 발생한 유도철사 부러짐)

  • Kim, Hak Ro;Yim, Tae Hoon;Kim, Byung Chul;Lee, Ho Jun;Oh, Hong Geun;Ju, Hyun Sik;Kim, Tae Jin;Kim, Young Bok
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.52-55
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    • 2016
  • Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.

A Modified Approach of Percutaneous Endoscopic Lumbar Discectomy (PELD) for Far Lateral Disc Herniation at L5-S1 with Foot Drop

  • Chun, Eun Hee;Park, Hahck Soo
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.57-61
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    • 2016
  • Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy.

Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy

  • Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won;Kim, Jong-Gue
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.192-195
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    • 2009
  • We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.