1.Postcardiac Injury Syndrome after Percutaneous Coronary Intervention.
Jin Seok PARK ; Dae Hyeok KIM ; Woong Gil CHOI ; Seoung Il WOO ; Jun KWAN ; Keum Soo PARK ; Woo Hyung LEE ; Jung Jin LEE ; Yong Jun CHOI
Yonsei Medical Journal 2010;51(2):284-286
The post cardiac injury syndrome is characterized by the development of a fever, pleuropericarditis, and parenchymal pulmonary infiltrates in the weeks following trauma to the pericardium or myocardium. According to previous reports, almost all cases develop after major cardiac surgery or a myocardial infarction. Recently, a few reports have described post cardiac injury syndrome as a complication of endovascular procedures such as percutaneous cardiac intervention. Here we describe an unusual case of post cardiac injury syndrome after a percutaneous coronary intervention.
Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects
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Heart Diseases/diagnosis/*etiology
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Humans
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Male
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Middle Aged
2.Stenting versus Bypass Surgery for the Treatment of Left Main Coronary Artery Disease.
Yonsei Medical Journal 2009;50(6):739-743
Based on data comparing coronary-artery bypass grafting (CABG) with medical therapy, the current guidelines recommend CABG as the treatment of choice for patients with left main coronary artery (LMCA) disease. Percutaneous coronary intervention (PCI) can be selectively performed in patients who are candidates for revascularization but who are ineligible for CABG. Current evidence indicates that stenting results in mortality and morbidity rates compared favorably with those seen after CABG. Data from several extensive registries and a large clinical trial may have prompted many interventional cardiologists to choose PCI with stenting as an alternative treatment option for such patients. In addition, these data may inform future guidelines and support the need for well-designed, adequately powered, prospective, randomized trials comparing the two revascularization strategies.
Angioplasty, Transluminal, Percutaneous Coronary/adverse effects/*methods
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Coronary Artery Bypass/*methods
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Coronary Artery Disease/*surgery/*therapy
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Humans
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Stents/adverse effects
3.Restenosis Following Coronary Angioplasty: Current Status.
The Korean Journal of Internal Medicine 2001;16(2):51-55
No abstract is available.
Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects/methods
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Coronary Disease/diagnosis/*therapy
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Human
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Incidence
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Prognosis
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Recurrence
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Risk Assessment
4.Thrombotic Thrombocytopenic Purpura after Percutaneous Coronary Intervention.
Jung Min LEE ; Seung Ho HUR ; Chang Wook NAM ; Seung Wook HAN ; Kee Sik KIM ; Yoon Nyun KIM ; Kwon Bae KIM
The Korean Journal of Internal Medicine 2006;21(2):120-122
Thrombotic thrombocytopenic purpura (TTP) is a rapidly progressive hematological syndrome defined by the pentad of thrombocytopenia, microangiopathic hemolytic anemia, neurologic abnormalities, fever and renal dysfunction. TTP has been associated with major surgical procedures and specific medications. However, there is no known previously reported case in which acute TTP occurred after a percutaneous coronary intervention (PCI). We report a case of TTP after a PCI, that presented with the pentad of symptoms, as well as hepatitis and pancreatitis.
Stents/*adverse effects
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Purpura, Thrombotic Thrombocytopenic/diagnosis/*etiology
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Humans
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Female
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Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects
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Aged
5.Initial and late results of Freedom coronary stent.
Young Keun AHN ; Kyung Tae KANG ; Myung Ho JEONG ; Jung Chaee KANG ; Yang Kyu PARK ; Ok Kyu PARK
The Korean Journal of Internal Medicine 2000;15(1):8-12
OBJECTIVES: Initial and late results after implantation of Freedom stents, a balloon expandable stainless steel coil stents were evaluated. METHODS: From Jun. 1996 to Nov. 1997, we implanted 123 Freedom stents in 122 lesions in 117 patients and performed follow-up coronary angiograms at 7.0 3.6 months after stents placement. Clinical courses after stenting and follow-up coronary angiographic findings were evaluated. Comparison of clinical, angiographic, and procedural factors according to the presence or absence of restenosis was performed. RESULTS: In 117 patients who underwent stents implantation, major complications were not observed. Follow-up coronary angiograms were performed in 47 stents in 41 patients (35+ACU-). Among 47 stents, angiographic significant restenosis (percent diameter stenosis +AD4- 50+ACU-) was observed in 13 (28+ACU-). Mean age in 41 patients was 59 9 years, with 27 male patients (66+ACU-). Indications for stents implantation were de novo lesions in 18 (38+ACU-), suboptimal results after PTCA in 18 (38+ACU-), bail-out lesions in 4 (9+ACU-) and restenotic lesions in 7 (15+ACU-). Lesion types by AHA/ACC classification were A in 1 (1+ACU-), B1 in 10 (21+ACU-), B2 in 17 (36+ACU-), and C in 19 (40+ACU-). Average lesion length was 13.7 9.0 mm, stent diameter 3.0 0.3 mm, and stent length 24.6 9.0 mm. There were no significant differences of the clinical, angiographic, and procedural characteristics according to the presence or absence of restenosis. CONCLUSION: Freedom coronary stents implantation is safely performed in various morphology of coronary lesions and no significant predictive factors on restenosis in follow-up coronary angiogram were observed.
Aged
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Angioplasty, Transluminal, Percutaneous Coronary/methods
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Angioplasty, Transluminal, Percutaneous Coronary/instrumentation+ACo-
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Angioplasty, Transluminal, Percutaneous Coronary/adverse effects
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Chi-Square Distribution
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Comparative Study
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Coronary Angiography
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Coronary Disease/therapy+ACo-
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Coronary Disease/radiography
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Female
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Follow-Up Studies
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Human
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Male
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Middle Age
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Predictive Value of Tests
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Probability
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Recurrence
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Stents+ACo-/adverse effects
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Treatment Outcome
6.The Effect of Insulin Resistance on Prognosis of Non-Diabetic Patients Who Underwent Percutaneous Coronary Intervention.
Kyeong Ho YUN ; Myung Ho JEONG ; Kye Hun KIM ; Young Joon HONG ; Hyung Wook PARK ; Ju Han KIM ; Young Keun AHN ; Jeong Gwan CHO ; Jong Chun PARK ; Nam Ho KIM ; Seok Kyu OH ; Jin Won JEONG ; Jung Chaee KANG
Journal of Korean Medical Science 2006;21(2):212-216
Insulin resistance is an important risk factor for coronary artery disease. However, there has been no data regarding its clinical effect on the outcomes of percutaneous coronary intervention (PCI) in non-diabetic patients. We analyzed 98 non-diabetic consecutive patients (59+/-11.5 yr, male:female=63:35) who underwent elective coronary angiography. The patients were divided into two groups: Group I (n=71; the value of HOMA-IR [homeostasis model assessment of insulin resistance] <2.6) and Group II (n=27; the value of HOMA-IR > or = 2.6). In-hospital and 30-day major adverse cardiac events (MACE) were compared between the two groups. The concentrations of fasting insulin and triglyceride were significantly higher in Group II than in Group I. Significant correlations were observed between the value of HOMA-IR and body mass index (r=0.489, p<0.001), levels of total cholesterol (r=0.204, p=0.045), triglyceride (r=0.334, p=0.001) and apolipoprotein B (r=0.212, p=0.038). PCI was performed in 59 patients (60.2%). In-hospital and 30-day MACE were higher in Group II than Group I (2.4% vs. 27.8%, p=0.008; 2.4% vs. 27.8%, p=0.008). Multivariate analysis revealed that the value of HOMA-IR > or = 2.6 was an independent predictor of MACE. Increased HOMA-IR level is an important prognostic indicator in non-diabetic patients underwent PCI.
Prognosis
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Models, Biological
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Middle Aged
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Male
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*Insulin Resistance
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Humans
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Homeostasis
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Female
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Coronary Stenosis/blood/physiopathology/therapy
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Coronary Arteriosclerosis/blood/physiopathology/therapy
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*Angioplasty, Transluminal, Percutaneous Coronary/adverse effects
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Aged
7.Initial clinical experience of intracoronary coil (Gianturco-Roubin) stents for management of acute dissection after balloon angioplasty.
Won Heum SHIM ; Jong Won HA ; Seung Yun CHO ; Si Hoon PARK ; Han Soo KIM ; Yang Soo JANG ; Namsik CHUNG ; Sung Soon KIM
Yonsei Medical Journal 1994;35(3):320-328
Dissections after percutaneous transluminal coronary angioplasty (PTCA) are risk factors for acute or subacute vessel closures. Intracoronary stenting was developed to avoid these complications by pressing the intimal and medial flaps against the vessel wall, thus reducing the risk of acute closure from thrombus formation. Thirty three coil (Gianturco-Roubin) stents were implanted into the coronary arteries of 32 patients with dissections after PTCA during the period of March 1993 to December 1993. The indications for stent implantation were acute closure in 6 (18.8%), threatened closure in 6 (18.8%) and suboptimal result in 20 (62.4%) patients. Stent insertion were successful in 30 (94%) patients. The diameter stenosis in an immediate angiographic findings after stenting was decreased from 87% to 18% by caliper estimation. Emergency coronary artery bypass graft surgery was required in 1 (3%) patient. A non-Q wave myocardial infarction occurred in 1 (3%) patient. Complications included hematoma of the arterial access site requiring blood transfusion in 4 (12.5%) patients and hemopericardium in 1 (3%) patient. Our initial clinical experience of flexible coil coronary stent imply that stenting is efficacious treatment for acute dissections that are causing acute or threatened closure following angioplasty. The long term follow-up result in all groups of patient who received coronary stents is needed for better evaluation of new devices and prognosis.
Acute Disease
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Adult
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Aged
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Aneurysm, Dissecting/etiology/*therapy
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Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects
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Coronary Aneurysm/etiology/*therapy
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*Coronary Vessels
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Female
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Human
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Male
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Middle Age
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*Stents
8.The Feasibility of Percutaneous Transradial Coronary Intervention for Chronic Total Occlusion.
Jang Young KIM ; Seung Hwan LEE ; Hyun Min CHOE ; Byung Su YOO ; Junghan YOON ; Kyung Hoon CHOE
Yonsei Medical Journal 2006;47(5):680-687
We evaluated the feasibility of the transradial coronary intervention (TRCI) in 85 consecutive patients with chronic total occlusion (CTO). Clinical, angiographic and procedural factors were compared between the success and failure groups. An overall success rate of 65.5% (57 of 87 lesions) was achieved with TRCI, and the most common cause of failure was an inability to pass the lesion with a guidewire. A multivariate analysis demonstrated that the most significant predictor of failure was the duration of occlusion (OR 1.064 per month, 95% CI 1.005 to 1.126, p = 0.03). The procedural success rate improved with use of new-generation hydrophilic guidewires. The 6 Fr guiding catheters were used in the majority of the 70 cases (81%). Five cases were crossed over to a femoral artery approach due to engagement failure of the guiding catheter into the coronary ostium because of severe subclavian tortuosity and stenosis in two cases, radial artery looping in one case, and poor guiding support in two cases. There were no major entry site complications. In conclusion, the radial artery might be a feasible vascular route in coronary interventions for CTO, with comparable procedural success and no access site complications.
Treatment Outcome
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Radial Artery/surgery
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Intraoperative Complications
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Humans
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Feasibility Studies
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Coronary Disease/diagnosis/*therapy
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Angioplasty, Transluminal, Percutaneous Coronary/adverse effects/*methods
9.Broken Guidewire Fragment in the Radio-brachial Artery During Transradial Sheath Placement: Percutaneous Retrieval via Femoral Approach.
Jang Young KIM ; Junghan YOON ; Hyun Sook JUNG ; Woo Jea KIM ; Byung Su YOO ; Seung Hwan LEE ; Kyung Hoon CHOI
Yonsei Medical Journal 2005;46(1):166-168
A case in which a 0.014" wire was broken during the sheath placement in the radial artery for transradial coronary procedure is described here, and a successful retrieval of it using conventional methods is also described. Through the left femoral artery, the 6 Fr guiding catheter was advanced down to the tip of the broken wire at the brachial artery, and the distal part of the broken guidewire was captivated into the guiding catheter. By inflating the balloon catheter inside of the guiding catheter, seized broken guidewire between the inflated balloon and the guiding catheter was removed successfully by withdrawing the whole system en bloc.
Aged
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Angioplasty, Transluminal, Percutaneous Coronary/*adverse
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effects/instrumentation/*methods
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Brachial Artery
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Coronary Arteriosclerosis/diagnosis
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Equipment Failure
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Female
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Femoral Artery
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Foreign Bodies/*etiology/*therapy
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Humans
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Radial Artery
10.Delayed Rupture of the Right Sinus of Valsalva into the Right Atrium after Percutaneous Coronary Intervention.
Seung Yong SHIN ; Hyung Joon JOO ; Sang Yup LIM ; Seong Mi PARK ; Soon Jun HONG ; Wan Joo SHIM ; Do Sun LIM
The Korean Journal of Internal Medicine 2009;24(4):388-392
Rupture of the sinus of Valsalva is an extremely rare complication after percutaneous coronary intervention (PCI). Because it usually results from the retrograde extension of a dissection of the right coronary artery and may quickly spread to involve the entire aorta, it can cause life-threatening complications such as aortic dissection. If the dissection remains localized, it can resolve spontaneously in the first month. Our patient experienced a delayed rupture of the right sinus of Valsalva into the right atrium at approximately 3 months after PCI.
Aged
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Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects
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Aortic Rupture/*etiology
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Echocardiography, Transesophageal
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Heart Atria/*pathology
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Humans
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Male
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*Sinus of Valsalva
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Time Factors