• 제목/요약/키워드: percutaneous coronary

검색결과 191건 처리시간 0.028초

Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery in Korea

  • Lee, Heeyoung;Lee, Kun Sei;Sim, Sung Bo;Jeong, Hyo Seon;Ahn, Hye Mi;Chee, Hyun Keun
    • Journal of Chest Surgery
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    • 제49권sup1호
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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.

심혈관 OCT의 임상적 응용 (Clinical Applications of Intracoronary OCT (Invited Paper))

  • 하진용;김중선;홍명기
    • 한국광학회지
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    • 제26권1호
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    • pp.1-8
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    • 2015
  • 심혈관 질환은 심장마비의 가장 흔한 원인으로 관상동맥의 협착으로 심근에 산소와 영양분을 제대로 공급하지 못하게 되어 발생하게 된다. 이를 내과적으로 치료하기 위해 심혈관 중재술이 시행되는데 이때 스텐트 삽입 여부, 위치, 크기, 그리고 스텐트 삽입 후 혈관벽과의 밀착 여부를 평가하기 위해 혈관 내 광간섭단층촬영(OCT, optical coherence tomography) 내시경 진단검사를 시행한다. 본 논문에서는 이러한 심혈관 OCT 원리와 기술 동향, 그리고 실제 의료현장에서 심혈관 OCT의 임상적 응용 및 활용가치를 소개하고자 한다.

Retrieval of a dislodged and dismounted coronary stent; using a rendezvous and snare technique at the brachial artery level via femoral approach

  • Jeong, Min-Woong;Sohn, Chang-Bae;Kim, Su Hong;Park, Jong-Ik;Park, Se-Ryeong;Min, Jun-Sik
    • Journal of Yeungnam Medical Science
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    • 제33권2호
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    • pp.138-141
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    • 2016
  • Coronary stent dislodgement during percutaneous coronary intervention, which occurs when the stent is passed through tortuous and calcified lesions, is not a rare complication. Without proper treatment, such as fixing with another stent in the coronary artery or removing the undeployed stent from the coronary artery or systemic artery system, this complication can cause serious problems. We experienced the unusual situation of a dismounted and dislodged coronary stent, in which retrograde retrieval to the radial artery was impossible during transradial coronary intervention. We report on use of a rendezvous and snare technique at the brachial artery level via femoral puncture, which resulted in resolution without surgery.

Hybrid Coronary Artery Revascularization for Takayasu Arteritis with Major Visceral Collateral Circulation from the Left Internal Thoracic Artery

  • Sim, Hyung Tae;Kim, Jeong-Won;Yoo, Jae Suk;Cho, Kwang Ree
    • Journal of Chest Surgery
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    • 제50권2호
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    • pp.105-109
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    • 2017
  • Coronary arterial involvement in Takayasu arteritis (TA) is not uncommon. Herein, we describe a case of TA with celiac trunk and superior mesenteric artery occlusion combined with coronary artery disease. Bilateral huge internal thoracic arteries (ITAs) and the inferior mesenteric artery provided the major visceral collateral circulation. After percutaneous intervention to the right coronary artery, off-pump coronary artery bypass grafting for the left coronary territory was done using a right ITA graft and its large side branch because of its relatively minor contribution to the visceral collateral circulation.

의료보장유형에 따른 Percutaneous Transluminal Coronary Angioplasty 입원 환자의 의료이용 차이 분석: Propensity Score Matching을 이용하여 (Difference in Healthcare Utilization for Percutaneous Transluminal Coronary Angioplasty Inpatients by Insurance Types: Propensity Score Matching Analysis)

  • 서은원;이광수
    • 보건행정학회지
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    • 제25권1호
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    • pp.3-10
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    • 2015
  • Background: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). Methods: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. Results: Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. Conclusion: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.

관상동맥 중재시술을 받은 환자의 시술 전후 건강행태 변화 비교 (Comparison of Health Behavior Change Before and After the Percutaneous Coronary Intervention among Coronary Artery Disease Patients)

  • 이정훈;이경수;황태윤
    • 농촌의학ㆍ지역보건
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    • 제41권3호
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    • pp.140-151
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    • 2016
  • Objectives: The purpose of this study was to investigate health behaviors of patients before and after percutaneous coronary intervention (PCI). Methods: The subjects of this study were 120 men and women whose age ranged from 40 years to 69 years among the patients who received percutaneous coronary intervention in Y university hospital that was located in Daegu city and who had diagnosed for 3 months or more and less than 2 years. Structured questionnaire was used to conduct self-administered survey from May 15 to October 12 in 2012. Results: Patients's health behavior score was ranged from 46 to 94 points after the PCI intervention. The score was $65.42{\pm}12.99$ points before and significantly increased up to $72.53{\pm}10.18$ points after the PCI intervention (p<.001). According to subcategory of health behavior, significant differences were found in scores of health responsibility (increased interest in health, watching of lecture on health and behavior to be punctual on counseling or medical treatment), diet, smoking, and drinking (p<.001, p=.039, p=<.001). However, no significant change was found in practice efforts such as exercise, eating habits and relaxation for stress management. Conclusions: In conclusion, it is necessary to provide education and counseling that enabling patients to improve smoking, drinking, practicing exercise and healthy eating habits.

Serum Copeptin Levels Predict Clinical Outcomes After Successful Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

  • Choi, Hyun-Jung;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Jeong, Myung Ho;Kim, Soo-Hyun;Shin, Myung-Geun;Ahn, Youngkeun
    • Annals of Laboratory Medicine
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    • 제38권6호
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    • pp.538-544
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    • 2018
  • Background: Serum copeptin has been demonstrated to be useful in early risk stratification and prognostication of patients with acute myocardial infarction (AMI). However, the prognostic value of copeptin after percutaneous coronary intervention (PCI) for clinical outcomes remains uncertain. We investigated the prognostic role of serum copeptin levels immediately after successful PCI as a prognostic marker for major adverse cardiac events (MACE; comprising death, repeat PCI, recurrent MI, or coronary artery bypass grafting) in patients with AMI. Methods: A retrospective study was performed in 149 patients with AMI who successfully received PCI. Serum copeptin levels were analyzed in blood samples collected immediately after PCI. The association between copeptin levels and MACE during the follow-up period was evaluated. Results: MACE occurred in 34 (22.8%) patients during a median follow-up of 30.1 months. MACE patients had higher copeptin levels than non-MACE patients did. Multiple logistic regression analysis showed that the increase in serum copeptin levels was associated with increased MACE incidence (odds ratio=1.6, P =0.005). Conclusions: A high level of serum copeptin measured immediately after PCI was associated with MACE in patients with AMI during long-term follow-up. Serum copeptin levels can serve as a prognostic marker in patients with AMI after successful PCI.

경피적 관상동맥중재술 후 급성으로 발생한 스테로이드 치료로 회복한 심근 손상 후 증후군 (Early-Onset Postcardiac Injury Syndrome after Percutaneous Coronary Intervention Recovered with Steroids)

  • 김민정;윤성보;이명동;김시호;김영우
    • The Korean Journal of Medicine
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    • 제93권6호
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    • pp.565-570
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    • 2018
  • PCIS는 심장 수술, 급성 심근경색 또는 경피적 관상동맥중재술 등에 의하여 발생한 심장 손상 후 발생하는 합병증이다. 본 저자는 경피적 관상동맥중재술 이후 급성으로 발생한 PCIS를 스테로이드를 사용한 약물로 치료하였기에 이를 문헌고찰과 함께 보고하는 바이다. 비스테로이드항염제에 반응하지 않는 PCIS 환자에게 스테로이드의 조기 투약이 도움이 될 수 있고 장기적인 유지 요법이 도움이 될 수 있음을 말해주고 있다.

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

  • 이지성;박의현;권정남
    • 동의생리병리학회지
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    • 제33권2호
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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.