• Title/Summary/Keyword: Percutaneous coronary interventions

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Development of Severity-Adjustment Model for Length of Stay in Hospital for Percutaneous Coronary Interventions (관상동맥중재술 환자의 재원일수 중증도 보정 모형 개발)

  • Nam, Mun-Hee;Kang, Sung-Hong;Lim, Ji-Hye
    • The Journal of the Korea Contents Association
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    • v.11 no.9
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    • pp.372-383
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    • 2011
  • Our study was carried out to develop the severity-adjustment model for length of stay in hospital for percutaneous coronary interventions so that we would analysis the factors on the variation in length of stay(LOS). The subjects were 1,011 percutaneous coronary interventions inpatients of the Korean National Hospital Discharge In-depth Injury Survey 2004-2006 data. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for percutaneous coronary interventions. There was variation of LOS in regional differences, size of sickbed and insurance type. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

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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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.

Literature Review of Nursing Intervention Studies for Patients Undergoing Percutaneous Coronary Intervention (경피적 관상동맥 중재술 환자에게 적용된 간호중재 연구 고찰)

  • Baek, Kyoung Hwa;Son, Youn-Jung
    • Perspectives in Nursing Science
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    • v.12 no.2
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    • pp.82-93
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    • 2015
  • Purpose: This study aimed to provide a systematic review of the evidence from controlled trials regarding nursing intervention studies on patients undergoing percutaneous coronary intervention, a discussion of the methodological problems that limit current research, and suggestions regarding future directions for research. Methods: Using a predefined protocol, 27 electronic databases were searched, studies selected, relevant data extracted, and the methodological quality of the studies assessed. Results: Twenty-seven studies were found reporting complex, generally heterogeneous interventions. The studies reported positive results, including self-efficacy, knowledge, and self-care. There were 6 randomized controlled trials, 19 quasi-experimental studies, and 2 only research group studies. In addition to support components, the interventions included elements of teaching, counseling, and education. Nursing interventions are still in the developmental and testing phase. Conclusion: The review demonstrated that a great deal is known about nursing intervention, the impact on a range of outcomes, and methodology. Although some useful evidence was reported for all interventions, further research needs to be carried out.

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.

Intracoronary Radiation Therapy (관동맥혈관 내 방사선 근접 치료)

  • Moon, Dae-Hyuk;Park, Seong-Wook;Hong, Myeong-Ki;Oh, Seung-Jun;Bom, Hee-Seung;Lee, Hee-Kyung
    • 대한핵의학회:학술대회논문집
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    • 2001.05a
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    • pp.24-34
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    • 2001
  • Restenosis remains a major limitation of percutaneous coronary interventions. Numerous studios including pharmacological approaches and new devices failed to reduce the restenosis rate except coronary stenting. Since the results of $BENESTENT^{1)}\;and\;STRESS^{2)}$ studies came out, coronary stenting has been the most popular interventional strategy in the various kinds of coronary stenotic lesions, although the efficacy of stenting was shown only in the discrete lesion of the large coronary artery. The widespread use of coronary stenting has improved the early and late outcomes after coronary intervention, but it has also led to a new and serious problem, e.g., in-stent restenosis. Intravascular radiation for prevention of restenosis is a new technology in the field of percutaneous coronary intervention. Recent animal experiments and human trials have demonstrated that local irradiation, in conjunction with coronary interventions, substantially diminished the rate of restenosis. This paper reviews basic radiation biology of intracoronary radiation and its role in the inhibition of restenosis. The current status of intracoronary radiation therapy using Re-188 liquid balloon is also discussed.

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Factors Influencing Life Satisfaction of Elderly Patients after Percutaneous Coronary Intervention (경피적 관상동맥중재술을 받은 노인의 삶의 만족도 영향 요인)

  • Han, Mi-Na;Kim, Hwasoon;Lee, Young-Whee
    • Journal of Korean Critical Care Nursing
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    • v.9 no.2
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    • pp.24-35
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    • 2016
  • Purpose: This study investigated the degree of stress, depression, mindfulness and life satisfaction of elderly patients who had undergone percutaneous coronary intervention (PCI) and identified factors influencing life satisfaction. Methods: Participants were 106 patients over 60 years who had undergone PCI in a university hospital. Results: The mean scores for stress, depression, mindfulness, and life satisfaction were $9.10{\pm}2.53$, $7.77{\pm}3.32$, $88.57{\pm}8.47$, and $17.40{\pm}5.38$ respectively. There were statistically significant differences in life satisfaction by main source of income (F = 4.74, p = .004) and perceived health status as compared with peer (F = 4.80, p = .010). Depression (p < .001) explained 38 % of the total variance of life satisfaction, and the explanatory power increased to 42 % when mindfulness (p = .035) was added. There were significant correlations among stress, depression, mindfulness and life satisfaction of the patients. Conclusions: Depression and mindfulness were significant influencing factors on subjects' satisfaction in life. To enhance the life satisfaction of the elderly patients after PCI, it is necessary to reduce depression and to develop mindfulness-based interventions.

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Health Locus of Control and Compliance of Treatment in Acute Coronary Syndrome Patients after Percutaneous Coronary Intervention (관상동맥중재술을 받은 급성관동맥증후군 환자의 건강통제위 및 치료지시이행)

  • Shin, Su-Jin
    • Korean Journal of Adult Nursing
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    • v.20 no.6
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    • pp.829-838
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    • 2008
  • Purpose: The purpose of this study was to explore the differences of health locus of control and treatment compliance according to general characteristics and severity in acute coronary syndrome(ACS) patients after percutaneous coronary intervention. Methods: This descriptive study was conducted with a convenient sample of 103 ACS patients. The dependent variables were measured by the scales for the Multidimensional Health Locus of Control and the Treatment Compliance. The collected data were analyzed by the Fisher's exact test, Chi-square and t-tests, and ANOVA using the SPSS program. Results: Pre-interventional severity was significantly different between men and women. In terms of internal health locus of control, there was a significant difference according to gender, educational status, economic status, and severity. The level of medication compliance was the lowest among the sub-scales of treatment compliance. Conclusion: These findings suggest that clinical nurses should evaluate the general characteristics and severity of the patients with ACS for providing tailored nursing interventions.

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Coronary CT Angiography-Based Assessment of Coronary in-Stent Restenosis: A Journey through Past and Present Trends (관상동맥 CT 조영술을 활용한 스텐트 재협착 평가: 과거와 현재 최신 동향으로의 여정)

  • Yoon Seong Lee;Eun-Ah Park;Whal Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.258-269
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    • 2024
  • Treatment of patients with coronary artery disease commonly involves the use of balloon-expandable stent placements, currently recognized as the most prevalent approach for coronary artery revascularization. Nevertheless, the occurrence of restenosis remains a significant complication following percutaneous coronary interventions. The diagnostic role of coronary CT angiography (CCTA) in detecting stent restenosis has limitations primarily attributable to challenges in accurately discerning the lumen, due to issues such as blooming and motion artifacts. As a result, many cases often necessitate a transition to conventional coronary angiography. However, recent advancements in CT technology have led to notable improvements in both sensitivity and specificity, underscoring the growing significance of CCTA as a diagnostic tool. The consistent reporting of high negative predictive value is particularly noteworthy. This review aims to explore the historical context, current status, and recent trends in diagnosing coronary artery stent restenosis using CCTA.