• Title/Summary/Keyword: Coronary intervention

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A survey on Patients' Compliance with Follow-up Coronary Angiogram after Coronary Intervention (관상동맥 중재술후 추적 관상동맥조영술 실천에 대한 조사연구)

  • Kim, Yoo Jung;Park, Oh Jang
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.30-39
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    • 2000
  • Coronary intervention is now a well established method for the treatment of coronary artery disease. Coronary restenosis is one of the major limitations after coronary intervention. So medical teams advise the patients to get the follow-up coronary angiogram in 6 months after coronary intervention to know if the coronary artery stenosis recurs or not. This study was done in order to know how many patients complied with the advice, and to identify the relative factors to the compliance with getting the follow-up coronary angiogram. The subjects were 101 patients (male: 58 female: 22, mean age: $61{\pm}15$), who received coronary interventions from Jan. 1st to Mar. 31st 1997, and their data were collected from them by questionnaires one year after intervention. The questionnaires consisted of family support scale, self efficacy scale and compliance with sick role behavior scale. The result may be summarized as follows. 1. The number of patients who complied with getting the follow-up coronary angiogram were 37 people(36.6%) and did not comply with it were 64 people(63.4%). All scores of family support(t=5.56, p<.0001), self efficacy (t=4.13, p<.0001) and compliance with sick role behavior(t=5.66, p<.0001) were significantly higher in the patients who got the follow-up coronary angiogram than in those who did not get it. But there was not any relative factor in demographic variables (p>.05). 2. The major motivations for getting follow-up coronary angiogram were recurrence of subjective symptom(40.5%), the advice of medical team(32.4%), and fear of recurrence (27.1%). The restenosis rate in patients who got the follow-up coronary angiogram was 37.8%. 3. The restenosis rate was higher in the patients who had subjective symptoms than in those who did not have any subjective symptom. So subjective symptom and restenosis rate showed a high positive correlation(r=39.9, p<.001). However, 27.2% of the patients who did not have any subjective symptom showed coronary restenosis. 4. The reasons why they did not get the follow-up coronary angiogram were economic burden(37.5%), improved symptom(34.4%), busy life schedule(10.9%), fear of invasive procedure(9.4%), negative reaction of family member(3.1%), no helper for patient(3.1%) and worry about medical team's mistake (1.6%). The relative fators on compliance with getting the follow-up coronary angiogram after coronary intervention were family support, self-efficacy and Compliance with sick role behavior. And the most important reason why the patients did not get the follow-up coronary angiogram after coronary intervention was an economic burden.

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Development of Algorithm for Nursing Interventions after Percutaneous Coronary Intervention (경피적 관상동맥중재술 후 간호중재 알고리즘 개발)

  • Ji, Hye-rim;Kim, Dong-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.1
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    • pp.18-29
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    • 2017
  • Purpose: The purpose of this study was to develop an algorithm for nursing care after percutaneous coronary intervention in order to improve patients' safety and prevent complications, because percutaneous coronary intervention is becoming a common treatment for coronary artery diseases. Methods: By reviewing related literatures and interviewing nurses, items and paths that were to be used in the algorithm for nursing care after percutaneous coronary intervention were drawn up and a draft algorithm was developed. The final algorithm was determined based on the results of the evaluation performed after clinical application. Results: According to the outcome after allowing nurses to apply the revised algorithm with 11 patients, suitability on items composing the algorithm were highly rated whereas promptness was lowly rated. Although the patients (n=11) to whom the algorithm was applied complained of less back pain (p=.001) and discomfort (p=.026) compared to the patients (n=17) to whom the algorithm was not applied, no significant difference in bleeding complication was found. Conclusion: The findings in the study support the clinical utilization of the algorithm for nursing care after percutaneous coronary intervention as the use of this algorithm reduced back pain and discomfort without increasing bleeding complications at the femoral puncture site.

Usefulness of Myocardial Perfusion SPECT after Percutaneous Coronary Intervention (PCI) (경피적 관상동맥 중재술(Percutanerous Coronary Intervention; PCI) 후 심근 관류 SPECT의 유용성)

  • Lee, Jong-Jin;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.114-117
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    • 2005
  • As the indication of percutaneous coronary intervention (PCI) has expanded to the more difficult and complicated cases, frequent restenosis is still expected after PCI. According to AHA/ACC guideline of the present time, routine use of myocardial perfusion single photon emission tomography (SPECT) is not recommended after coronary intervention, but symptom itself or exercise EKG is not enough for the detection of restensis or for the prediction of event-free survival. In high risk and/or symptomatic subjects, direct coronary angiography is required myocardial perfusion SPECT could detect restenosis in 79% of the patients if performed 2 to 9 months after PCI. Reversible perfusion decrease in the myocardial perfusion SPECT is known to be the major prognostic indicator of major adrerse cardiac event in PCI patients and also the prognosis is benign in the patients without reversible perfusion decrease. Though the cumulated specificity is 79% in the literature and optimal timing of myocardial perfusion SPECT is in controversy, SPECT is recommended even in asymptomatic patients at 3 to 9 months after PCI. Considering the evidences recently reported in the literature, myocardial perfusion SPECT is useful for risk stratification and detection of coronary artery restenosis requiring re-intervention in the asymptomatic patients after PCI.

The Effects of Heat Therapy on Low Back Pain, Blood Pressure and Pulse Rate after Percutaneous Coronary Intervention (경피적 관상동맥 중재술 후 온요법이 요통, 혈압 및 맥박에 미치는 효과)

  • Yun, So-Young;Cho, Bok-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.3
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    • pp.348-355
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    • 2011
  • Purpose: This study was done to examine the effects of heat therapy on low back pain, blood pressure and pulse rate after percutaneous coronary intervention. Method: The participants in this study were 40 patients who were admitted after having percutaneous coronary intervention. The experimental group, 20 patients, had heat therapy and the control group, 20 patients, maintained a supine position for 12 hours after the intervention. Back pain (VAS), blood pressure and pulse rate were measured just after removal of the sheath, and at 2-hour intervals up to 6 hours. Data were analyzed using SPSS 15.0. Results: The experimental group had significantly lower VAS for low back pain (F=23.44, p=.001). However no significant differences were found between two groups for blood pressure and pulse rate. Conclusion: The findings indicate that heat therapy is effective in reducing low back pain in patients who have had percutaneous coronary intervention. Therefore, heat therapy could be used as nursing intervention percutaneous coronary intervention.

Brachytherapy in Coronary Artery Disease (관상동맥질환의 방사성동위원소 치료)

  • Song, Ho-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.113-119
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    • 2006
  • Coronary artery disease is a loading cause of morbidity and mortality across the world. Percutaneous coronary intervention has become the major technique of revascularization. However, restenosis remains a major limitation of this procedure. Recently the need for repeat intervention due to restenosis, the most vexing long-term failure of percutaneous coronary intervention, has been significantly reduced owing to the introduction of two major advances, intracoronary brachytherapy and the drug-eluting stents. Intracoronary brachytherapy has been employed in recent years to prevent restenosis lesions with effective results, principally in in-stent restenosis. Restenosis is generally considered as au excessive form of normal wound healing divided up in precesses: elastic recoil, neointimal hyperplasia, and negative vascular remodeling. Restenosis has previously been regarded as a proliferative process in which neointimal thickening, mediated by a cascade of inflammatory mediators and other factors, is the key factor. Ionizing radiation has been shown to decrease the proliferative response to injury in animal models of restenosis. Subsequently, several randomized, double blind trials have demonstrated that intracoronary brachytherapy can reduce the rates of both angiographic restenosis and clinical event rates in patients undergoing percutaneous coronary intervention for in stent restenosis. Some problems, such as late thrombosis and edge restenosis, have been identified as limiting factors of this technique. Brachytherapy is a promising method of preventing and treating coronary artery restenosis.

The Analysis of Risk Factor Management Programs for Patients with Coronary Artery Disease (관상동맥질환자를 위한 위험요인관리 프로그램 분석)

  • Bang, So-Youn;Park, Mi-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.16 no.1
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    • pp.27-36
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    • 2013
  • Purpose: This study was performed to analyse the trends of risk factor management programs for patients with coronary artery disease. Methods: Using PubMed, 35 intervention studies related to risk factor management programs among randomized controlled trials searched with the key words of coronary artery disease and coronary heart disease. Collected studies were analysed according to the characteristics of studies and participants, method and content of intervention, and outcome indicator and its effects. Results: The mean period of intervention was $28.7{\pm}26.8$ weeks, the mean frequency was $3.0{\pm}2.0$ times per week, and the duration of one session was below 60 minuets in 65.8% of the reviewed studies. The interventions were counselling, exercise, education, and cognitive behavior therapy. Counselling was applied most frequently in previous studies. The outcomes of intervention had been measured with anthropometric, physical, physiological, psychological, behavioral, and cognitive aspects, but the effect of the intervention was inconsistent among the studies. Conclusion: Based on the results of this study, systematic and comprehensive cardiac rehabilitation program consisted of counselling, exercise, and education should be developed and performed for health management and relapse prevention of patients with coronary artery disease.

Successful transradial intervention via a radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter

  • Yoon, Shin-Eui;Park, Sangwook;Ahn, Sung Gyun
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.94-98
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    • 2018
  • The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.

Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1127-1130
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    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

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Intractable Coronary Spasm Requiring Percutaneous Coronary Intervention after Coronary Artery Bypass Grafting in a Patient with Moyamoya Disease

  • Kim, Hyeon A;Kim, Young Su;Kim, Wook Sung
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.150-153
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    • 2021
  • Moyamoya disease (MMD) is characterized by progressive steno-occlusive lesions of the distal or proximal branch of the internal carotid arteries, and cerebrovascular symptoms are its major complications. Extracranial vascular involvement including the coronary artery has been reported, and some case reports have described variant angina or myocardial infarction. However, no report has yet described a case of myocardial infarction after coronary artery bypass grafting (CABG). Here, we present a patient with MMD who suffered cardiac arrest caused by myocardial infarction due to a coronary spasm after offpump CABG and who was discharged successfully after treatment with a veno-arterial extracorporeal membrane oxygenator and percutaneous coronary intervention.

Development and Evaluation of a Self Care Education Program for Elderly Patients with Percutaneous Coronary Intervention (경피적 관상동맥 중재술을 받은 노인환자의 자가간호 교육프로그램 개발 및 평가)

  • Jo, Gyeong-Jin;Yang, Jin-Hyang
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.2
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    • pp.266-275
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    • 2014
  • Purpose: The purpose of this study was to identify the effects of the education program to promote self care for elderly patients with percutaneous coronary intervention. Method: The research was a quasi-experimental study using a nonequivalent control group non-synchronized design. The participants was 56 patients, 28 in the experimental group and 28 in the control group. A pretest and a posttest were conducted to measure main variables. The self care education program, consisting of flash animation, leaflet and telephone counseling, was given for the experimental group. Data were analyzed using ${\chi}^2$, Fisher's exact test, and independent t-test with SAS statistics program. Results: There were statistically significant increase in knowledge and self care behavior, and decrease in anxiety by difference between a pretest and a posttest in the experimental group compared to that in the control group. Conclusion: The result of this study indicate that the self care education program is effective in increasing knowledge and self care behavior, and in decreasing anxiety for elderly patients with percutaneous coronary intervention. Therefore, it can be usefully utilized in the field of nursing for elderly patients with percutaneous coronary intervention.