• Title/Summary/Keyword: percutaneous coronary

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Percutaneous Cardiopulmonary Bypass Support in a Patient with Acute Myocardial Infarction by Stent Thrombosis Complicated with Ventricular Tachycardia (스텐트 혈전에 의한 재발성 심실성 빈맥을 동반한 급성 심근경색에 경피적 심폐순환보조)

  • Kim Sang-Pil;Lee Jun-Wan
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.399-402
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    • 2006
  • Stent thrombosis is a rare complication after percutaneous coronary intervention (PCI), but it might be related to fatal outcomes. We report a case of patient who suffered from acute myocardial infarction complicated with cardiogenic shock and ventricular tachycardia caused by stent thrombosis and successfully resuscitated by percutaneous cardiopulmonary bypass support.

CT Angiography-Derived RECHARGE Score Predicts Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

  • Jiahui Li;Rui Wang;Christian Tesche;U. Joseph Schoepf;Jonathan T. Pannell;Yi He;Rongchong Huang;Yalei Chen;Jianan Li;Xiantao Song
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.697-705
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    • 2021
  • Objective: To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGECCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Materials and Methods: One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGECCTA scores were calculated and compared with RECHARGECA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores. Results: The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGECCTA score and the RECHARGECA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGECCTA score was higher than the RECHARGECA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGECCTA and RECHARGECA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGECCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGECCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665-0.717, all p > 0.05). Conclusion: The non-invasive RECHARGECCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGECCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

Effect of Triple Compared to Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Percutaneous Coronary Intervention (관상동맥 약물 용출 스텐트 삽입 후 항혈소판제제 3제요법과 2제요법의 임상적 효과 비교)

  • Ye, Kyong-Nam;Kim, Jeong-Tae;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.113-122
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    • 2012
  • ACC/AHA/SCAI Guideline recommends for administration dual antiplatelet therapy after drug-eluting stent (DES) to prevent restenosis and stent thrombosis in patients with percutaneous coronary intervention (PCI). Recently triple antiplatelet therapy including cilostazol is known to reduce restenosis and stent thrombosis significantly after DES implantation. However, there is lack of data providing the efficacy of triple antiplatelet therapy. The purpose of this study is to evaluate the clinical effects of the triple therapy after DES implantation compared with the dual therapy. This retrospective study collected data from medical charts of 251 patients who received DES implantation between Jul 2006 and Jun 2008. They received either dual antiplatelet therapy (N = 154 clopidogrel and aspirin; Dual group) or triple antiplatelet therapy (N = 97 cliostazol, clopidogrel and aspirin; Triple group). Major adverse cardiac event rates (MACE, included total death, myocardial infarction, target lesion revascularization) at 12 months, 24 months, stent thrombosis, rates of bleeding complications and adverse drug reactions were compared between these two groups. Compared with the dual group, the triple group had a similar incidence of the MACE rates at 24months (12.3% vs. 12.4%, p = 0.99). There is no difference in overall stent thrombosis between two groups (Dual group 2.6% vs. Triple group 4.1%, p = 0.5). Subgroup analysis showed that diabetic patients got more benefit in reducing MACE rates but, there is no statistical difference. Bleeding complications and adverse drug effects were not different significantly. As compared with dual antiplatelet therapy, triple antiplatelet therapy did not reduce the 12-months, 24-months MACE rates and stent thrombosis. Bleeding complications and adverse drug effects were not different.

Case Report of Korean Medical Treatment of Chest Pain After Percutaneous Coronary Intervention (경피적관상동맥중재술을 시행한 후 발생한 흉통(胸痛)에 대한 한방치료 1례)

  • Min, Seon-woo;Kim, Hak-kyeom;Moon, Ji-seong;Kim, Ye-seul;Park, Ji-yoon;Jeong, Ji-cheon
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.184-196
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    • 2021
  • Objectives: This case report presents the effects of Korean medical treatment in a patient with chest pain after percutaneous coronary intervention (PCI). Methods: An 80-year-old woman was treated with Korean herbal medicine, acupuncture, and cupping therapy. Chest pain, sore tongue, and headache were assessed daily using a numeric rating scale (NRS). Results: After 15 days of treatment, chest pain disappeared, as reflected by an NRS change from 9 to 0, and headache was relieved (NRS decreased from 9 to 2). On the eighth day of treatment, the sore tongue was also relieved, as reflected by an NRS change from 9 to 0. Conclusion: These results show that chest pain after PCI can be relieved with Korean medical treatment, and it is expected that major adverse cardiac events (MACEs) may be prevented with Korean medical treatment. However, additional well-designed studies are required to confirm these findings.

Clinical outcomes and characteristics of acute myocardial infarction patients with developing fever after percutaneous coronary intervention

  • Jae-Geun Lee;Yeekyoung Ko;Joon Hyouk Choi;Jeong Rae Yoo;Misun Kim;Ki Yung Boo;Jong Wook Beom;Song-Yi Kim;Seung-Jae Joo
    • Journal of Medicine and Life Science
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    • v.19 no.2
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    • pp.46-56
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    • 2022
  • The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

Restenosis and Remodeling (관동맥성형술 후의 혈관 재협착 및 재형성)

  • Chae, Jei-Keon
    • 대한핵의학회:학술대회논문집
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    • 1999.05a
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    • pp.205-208
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    • 1999
  • Percutaneous Transluminal Coronary Angioplasty (PTCA) remains limited by restenosis that occurs in 30 to 50% of patients with coronary artery disease. During the last decade, numerous agents have been used to prevent restenosis. Despite positive results in animal models, no pharmacological therapy has been found to significantly decrease the risk of restenosis in humans. These discrepancies between animal models and clinical situation were probably related to an incomplete understanding of the mechanism of restenosis. Neointimal thickening occurs in response to experimental arterial injury with a balloon catheter. Neointimal formation involves different steps: smooth muscle cell activation, proliferation and migration, and the production of extracellular matrix. The factors that control neointimal hyperplasia include growth factors, humoral factors and mechanical factors. Arterial remodeling also plays a major role in the restenosis process. Studies performed in animal and human subjects have established the potentials for "constrictive remodeling" to reduce the post-angioplasty vessel area, thereby indirectly narrowing the vessel lumen and thus contributing to restenosis. The reduction of restenosis rate in patients with intracoronary stent implantation has been attributed to the preventive effect of stent itself for this negative remodeling. In addition to these mochanisms for restenosis, intraluminal or intra-plaque thrombus formation, reendothelialization and apoptosis theories have been introduced and confirmed at least in part.

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Influencing Factors on Health Behavior Compliance in Men Who Underwent Percutaneous Coronary Intervention: Focusing on the Elapsed Period (관상동맥중재술을 받은 남성의 건강행위 이행에 미치는 영향요인: 경과기간을 중심으로)

  • Ha, Haeng-Ju;Seo, Minjeong
    • Journal of Digital Convergence
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    • v.19 no.12
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    • pp.661-673
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    • 2021
  • This study is a descriptive study to understand the effect on the health behavior compliance of men who got coronary intervention, focusing on the elapsed period. The subjects of this study were 249 men who underwent coronary intervention at a university hospital, and the collected data were analyzed using Stepwise multiple regression. As a result of the study, the influencing factors the implementation of healthy behaviors were self-regulation(β=0.35, p<.001), risk factors among educational request(β=-0.26, p<.001), and the elapsed period(β=0.19, p<.001), marital status(β=0.15, p=.001), educational level(β=-0.12, p=.035), and the total explanatory power was 29.1%. IIn order to increase the health behavior performance of male patients who underwent coronary intervention, it is necessary to develop a program that can strengthen the autonomous motivation of subjects with high severity and elapsed time of less than 1 year and more than 1 year.

Analysis of Psychosocial Factors Affecting Health Behavior Adherence among Community-dwelling Older Adults undergoing Percutaneous Coronary Intervention (관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향 미치는 심리사회적 요인 분석)

  • Jeon, Hye-Won;Chang, Hee-Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.231-244
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    • 2020
  • This study is a descriptive research to analyze psychosocial factors affecting health behavior adherence among community-dwelling older adults undergoing Percutaneous Coronary Intervention. Data were collected with structured questionnaires from 126 patients discharged after hospitalization from a university hospital in J city, Gyeongnam, from July 15 to October 2 in 2018, and analyzed using SPSS/WIN 21.0. The result shows that the general characteristics, such as existence of spouse, education level, subjective health status, and subjective life satisfaction, have a significant influence on health behavior adherence. The research also identifies that medical support and resilience are positively correlated with health behavior adherence. In contrast, perceived stress, 3 sub-categories from perceived stress such as, family relations, anxiety and withdrawal, poverty and finance, and depression are negatively correlated. In the multiple regression analysis, resilience, perceived stress from poverty and finance, education level, and subjective life satisfaction explained 27.9% of health behavior adherence among older adults undergoing Percutaneous Coronary Intervention. Based on the results of this study, it is necessary to develop and apply a nursing intervention program to improve the health behavior adherence of local older adults who had Percutaneous Coronary Intervention.

Surgical Treatment of Coronary Artery Occlusive Disease (관상동맥 협착증의 외과적 치험 -30례의 임상적 결과-)

  • 김병열
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.994-1000
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    • 1995
  • Thirty patients with ischemic heart disease underwent coronary artery bypass grafting [CABG from 1985 through 1994. There were 16 males and 14 females whose age ranged from 41 to 72 years old. Preoperative diagnoses were unstable angina in 13 of patients, stable angina in 8, postmyocardial infarction state in 7, and state of failed percutaneous transluminal coronary angioplasty [ PTCA in 2. The patterns of disease were single vessel involvement [ 17cases , double vessel involvement [ 7 cases , triple vessel involvement [ 3 cases , Lt main lesion including Lt. ostial lesion [ 3 cases . Saphenous vein grafts were used in 27/30 patients [ 90% , and internal mammary artery grafts were used in 6/30 patients [ 20% . The hospital mortality was 13.3% and all survivors were asymptomatic and improved over their preoperative status.

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Post-Coronary Artery Bypass Grafting Myocardial Ischemia Caused by an Overgrown Left Internal Thoracic Artery Side Branch

  • Kim, Eung Re;Oh, Se Jin;Kang, Hyun-Jae;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.465-467
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    • 2014
  • We present a patient who developed recurrent angina after coronary artery bypass grafting (CABG). Myocardial single-photon emission computed tomography (SPECT) demonstrated deterioration in the myocardial perfusion, and coronary angiography revealed an overgrown side branch of the grafted left internal thoracic artery (ITA); otherwise, there were no significant changes compared with previous imaging studies obtained after the CABG. After percutaneous embolization of the grafted left ITA side branch, the angina was resolved and myocardial SPECT showed improved perfusion.