Objective To explore how older patients self-manage their coronary heart disease (CHD) aider undergoing elective percutaneous transluminal coronary angioplasty (PTCA). Methods This mixed methods study used a seque...Objective To explore how older patients self-manage their coronary heart disease (CHD) aider undergoing elective percutaneous transluminal coronary angioplasty (PTCA). Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients (n = 93) approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings in- formed the purposive samplhag for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualita- tive data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants (n = 47) classified as 65 years of age or older. Results 78.7% (n = 37) of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% (n = 16) thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% (n = 19) would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less (P = 0.02) and smoked less (P = 0.01) than their younger counterparts in the study. Age did not seem to affect PTCA patients' likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption (P = 0.237). Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants' likelihood to alter lifestyle factors.展开更多
Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the ma...Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS展开更多
Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to asses...Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to assess the clinical profile, angiographic status, and prevalence of restenosis in patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in LMCA. Materials and Methods: This observational cohort study included 17 patients who underwent PTCA in LMCA during one-year study period at tertiary care centers in Government Medical College, Kozhikode, India. Data including various risk factors, clinical and angiographic details, stent used, procedural complications and outcomes including rate of restenosis were analyzed. Results: A total of 17 patients (mean age 53.88 ± 9.80 years) with 76.47% of males were included in the study. Smoking and hypertension were the most common risk factors presented in 52.94% and 47.06% of patients respectively. Single vessel disease (SVD) of LMCA was the most common pattern observed in 47.10%;the rate of restenosis was observed in 11.76% patients. Revascularization was performed in one patient (5.88%) with coronary artery bypass graft and in one patient (5.88%) with PTCA using drug eluting stent (DES). The overall procedural success was 88.24% in this study. Survival rate was 100% at one-year follow-up period. Conclusion: Our study involved patients who underwent PTCA in LMCA, showed smoking as a most prevalent risk factor for coronary artery disease and SVD as a most common pattern, comparatively low rate of restenosis and 100% of survival rate at one-year follow-up period.展开更多
Percutoneous transiuminal coronary anginplesty(PTCA)was performed in33 patients of coronary heart diseases(male 30 cases,female 3 cases, meanage 54.2) with Gruentzig’s method.Of all the 33 patients,there were 26narro...Percutoneous transiuminal coronary anginplesty(PTCA)was performed in33 patients of coronary heart diseases(male 30 cases,female 3 cases, meanage 54.2) with Gruentzig’s method.Of all the 33 patients,there were 26narrow parts in 20 cases of the single branch lesions,27 narrow parts in 11cases of the double branch lesions and 11 narrow parts in 2 cases of thethree branch lesions.In 48 branches with lesion vessels,there were 27branches of the left anterior descending coronary arteries (LAD),7 branchesof the left cicumflex coronary arteries(LCX)and 13 branches of the rightcoronaw arteries.The narrow degrees varied from 75% to 100%. The resultswere that,of 33 patients,48 branches of lesion vessels and 64 narrow parts,the successful rates of dilation were 96.9%,87.5%,85.9%,respectively.Ventricular fibrillation occurred in one case during the procedure,whichsoon recovered sinus rhythm through cardioversion.Symptoms of thesuccessful 32 patients were lmproved obviously or diappeared after PATC.Combining with the documents,we think that the successful rates are higherin type A lesion undergoing PTCA.When PTCA for the multiple branchlesions are performed,we ought to master the principle of dilating the mainlessinos in advence.The long-tube lesions were dilated by the long balloonfitting for these lesions.The causes of failure of PTCA in the severe narrowlesions are mainly the the guilding wires or the balloon catheters cann’t passthrough the lesion parts,in addition,the complication problems in PTCA arealso discussed.展开更多
Background: Many patients are affected by idiopathicbronchiolitis obliterans organizing pneumonia (BOOP). There are several known causes of BOOP, and several systemic disorders have BOOP as an associated primary pulmo...Background: Many patients are affected by idiopathicbronchiolitis obliterans organizing pneumonia (BOOP). There are several known causes of BOOP, and several systemic disorders have BOOP as an associated primary pulmonary lesion. Numerous agents including cytotoxic and noncytotoxic drugs have the potential to cause pulmonary toxicity. Descriptions of amiodarone-related BOOP continue to be reported throughout the world. Case Report: We reported a patient with original clinical presentation who developed recurrent sustained ventricular tachycardia (SVT) despite the presence of implantable cardioverter-defibrillator (ICD), hypoxaemia and interstitial pneumonitis in both lung bases. After percutaneous transluminal coronary angioplasty, he developed bronchiolitis obliterans organizing pneumonia (BOOP). Conclusions: To our knowledge, such complications after percutaneous coronary procedure in patients with amiodarone therapy for arrhythmia prophylaxis, are not very frequent in literature.展开更多
The purpose of this study was to demonstrate the relation between the transientchanges of electrocardiogram(ECG)on body surface during balloon dilating inpercutaneous transluminal coronary angioplasty(PTCA) and improv...The purpose of this study was to demonstrate the relation between the transientchanges of electrocardiogram(ECG)on body surface during balloon dilating inpercutaneous transluminal coronary angioplasty(PTCA) and improvement of theresidual myocardial viability after PTCA,Eighteen patients with twenty-threecoronary arteries narrowing above 70% were underwent PTCA and myocardialviability was examined with 99mTc-MIB1 Singlephoton Emission ComputedTomography(SPECT)before and after the procedure.During the balloon dilating30-60s,the ECG with leads Ⅱ,Ⅲ.avF.V4 weve recorded.There were 15 caseswith ECG changes of T wave.ST-Seg-ment and QRS axis(65.2%,47 8% and26.1%.respectively),3 case without ECG chanse.More than 50% change of Twave altitude was scored as 1.ST segment shift(elevation≥lmm or depression≥0.5mm.10mm=lmv)as 2.QRS axis deviation≥15 as 3.Myocardial viabiliiy.was evaluated by SPECT with four-point of nine segments of the left ventricularwall.The integral value of ECG change dung PTCA was closely correlated withthe change value of SPECT(SPECT△)(r=0.74,p【0.01).The sensitivity of themethod was 80%;specificity 100%;the positive predictive value 100%;the negativepredictive value 50%;the accuracy 83.3%.This method was simple,useful and.excellent in evaluating myocardial viability.The rest myocardial viability afterPTCA was higher than it was before PTCA(21.2±3.8 vs 17.6±3.6point,P【0.01).The hibernating myocardial viability was improved post PTCA.展开更多
To study the damage effect of percutaneous transfuminalcoronary angioplasty(PTCA)on myocardium,wedetermined the serum CPK and CPK-MB level in 35 casesof patients with coronary henrt disease(CHD)beforePTCA and at 6th,1...To study the damage effect of percutaneous transfuminalcoronary angioplasty(PTCA)on myocardium,wedetermined the serum CPK and CPK-MB level in 35 casesof patients with coronary henrt disease(CHD)beforePTCA and at 6th,12th,24th hour,2nd,3rd day afterPTCA.The results showed that after PTCA,the serumCPK and CPK-MB in 21 of 35 case of patients wised at12th hour.2nd day reached the peak level.But comparedwith others,it has no significant different(P】0.05).TheCPK and CPK-MB decreased to normal level at 3rd day.Itis suggested that PTCA has no significant damage effect onmyocardium.展开更多
Percutancous transluminal coronary angioplasty was pcrfonned in 70patients with high risk characteristics from Jan.1998 toDcc.1997 These factors include age】70(10patients),unstableangina(35patients),ejection fraction...Percutancous transluminal coronary angioplasty was pcrfonned in 70patients with high risk characteristics from Jan.1998 toDcc.1997 These factors include age】70(10patients),unstableangina(35patients),ejection fraction【40%(7 patients),multivesseldisease(50patients).There were 96 lesions(79 vessels)dilated,amongthem type Alesion 15,type B lesion 52,type C lesion 29.Autoperfusion balloon was used in 7 patients, coronary stcnl wasimplantcd in 50 paticnts.One patient undcrgoing directional coronaryathrectomy(DCA).The clinical success rate was 91.5% and lesionsuccess rate was 89.6%.Average predilation stenosis was 89.5+8.2%and average postdilation stenosis was 16.9+6.2%.Two patients diedfrom abrupt vessel closureno acule myocardial infarction andemergency coronary bypass operation.The considerations in selectionand management of these high risk patients were discussed. The resultsshowed that PTCA can be performed safely in the complex cases.展开更多
Objective:An analysis of 130 cases admitted(during December.1993--December,1997)is reported b.All the patients were treated withprcutnous Transluminal Coronary agioplty (PTCA).In addition to it10 cases underwent a...Objective:An analysis of 130 cases admitted(during December.1993--December,1997)is reported b.All the patients were treated withprcutnous Transluminal Coronary agioplty (PTCA).In addition to it10 cases underwent a second PTCA because of rt.The totalnumber is 140 cases.Thi paper up the pathlolgic changs ratecharacterized by coronary lesion in type A,B,and C<sub>1</sub> percentage ofvaodilation;rate of success in type A,B,and C<sub>1</sub> and the rate ofrt.Method:Coronary arteriography was performed in most cases add then PTCAwas exercised on selective cases with 7-10 days interval according tothe t plan.Coronary arteriography and PTCA were done synchronouslyin the rest cases.Kissing bicatheter technique were employed in 3cases because of bifurcated lesion and PTCA with insertion of a stntinto the spaces of the coronary artery at a diagonal was applied to 1case.Results:Classification of coronary lesion:Type A 33 cases (23.67%),B57 (40.71%),and C 50 (35.71%).Number of coronary artery:single 40 (2857%),double 59 (42.14%),triple 39 (27.85%),main 2 (1.44%).Vasodilation:LAD 116(74.35%),LCX 22(14.1%),RCA 16(10.25%),Middle 2(1.2%).Rate of success:A 33 (100%),B 57 (94.8%),C 50 (94%).Total rate ofsuccess:95.8% Rate of failure:6 cases(4.2%),of which B 3 and C 3respectively,and one of limited myocardial infarction,one of coronaryabnormality,and others of 99-100% t with one failure of balloonwire to the lesion.Rtsis:10 cases had angina ptori 2-6 monthsafter PTCA and a second PTCA revealed LAD rtnosis,rated 5.7%.Concluon:In this group t lesion (76.42%) was found in Type B andType C,while lesion in Type A was L (23.5%).That’s why highsuccess existed in Type A (100%),while Type B and C with complicatedlesion needed complicated performance and rated low in success (94-94.8%)Vdilation:LAD】LCX】RCA.The rate of success lies in the degree ofcomplicated lesion,balloon wire and selection of catheter.Theinsertion of a tnt into the coronary artery might be the best way totreat PTCA t.展开更多
We reported 11 cases of excimer laser coronary angioplasty (ELCA). All were males, the average age being 59.7 years. Five patients had sustained previous myocardial infarctions with post-infarction angina in 2 cases a...We reported 11 cases of excimer laser coronary angioplasty (ELCA). All were males, the average age being 59.7 years. Five patients had sustained previous myocardial infarctions with post-infarction angina in 2 cases and 6 presented angina only. Coronary angiograms showed stenosis in LAD (N9), LCX(N6) and RCA (N6). According to the ACC/AHA classification, 6 were categorized as type B, and 5 type C. ELCA with adjunctive PTCA were performed in all 8 patients, 1. 3 mm (energy density 14. 5 mJ) and 1.6 mm (energy density 21.0 mJ) laser catheters with 20Hz pulse frequency were used There was one failure and in another ELCA was successful but death followed the procedure. The overall result was laser success 10 out of the 11 cases and procedure success 9.展开更多
Objective To prospectively evaluate the safety and therapeutic efficacy ofdalteparin in patients with high risk non-ST- elevation acute coronary syndromes (ACS) during percutaneous coronary intervention (PCI). Met...Objective To prospectively evaluate the safety and therapeutic efficacy ofdalteparin in patients with high risk non-ST- elevation acute coronary syndromes (ACS) during percutaneous coronary intervention (PCI). Methods A total of 175 patients with high risk non-ST-elevation ACS were randomly assigned to 2 groups [dalteparin group and unfractionated heparin (UFH) group]. The patients in dalteparin group were given dalteparin at a dose of 5,000U subcutaneously soon after diagnosis and then an additional 60U/ kg intravenous bolus ofdalteparin before emergent PCI. Vascular access sheaths were removed immediately after PCI or coronary artery angiography; the patients in UFH group were given UFH intravenously at a dose of 25mg just before PCI and an additional 65mg bolus was administered if angiographic findings showed that the patients were suitable for percutaneous transluminal coronary angioplasty (PTCA). Sheaths were removed at 4-6 hours after PCI; Results Eighty-three patients in dalteparin group underwent PCI while 82 patients in UFH group underwent PCI; anti-Xa activities of 52 patients in daltepafin group were measured. The average anti-Xa activity was (0. 83± 0.26) U/ml at 15 minutes after intravenous injection of dalteparin and anti-Xa〉0.SU/ml was obtained in 96.1% of the patients; hematomas at puncture sites were significantly fewer in dalteparin group as compared with UFH group (2.3% vs 9.2%, P 〈 0.05); none of the patients in 2 groups suffered major bleeding events. No death, acute arterial reocclusion or emergent revascularization events occurred at 30 days after PCI. Conclusions Our study demonstrated that early subcutaneous injection ofdalteparin at a dose 5,000U after diagnosis and an additional 60U/kg intravenous bolus ofdalteparin before PCI is safe and efficacious for patients with high risk non-ST-elevation ACS undergoing emergent PCI.展开更多
Background and Objective: Coronary artery disease (CAD) is the leading cause of sudden death. In this article, we compared patients’ illness perception (IP), treatment adherence and coping mechanisms of patients unde...Background and Objective: Coronary artery disease (CAD) is the leading cause of sudden death. In this article, we compared patients’ illness perception (IP), treatment adherence and coping mechanisms of patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Methods: In this descriptive, prospective observational study IP, treatment adherence and coping of 140 patients were evaluated pre-PTCA, at the time of hospital discharge and 1 to 3 months post-PTCA by Illness Perception Questionnaire, Morisky Treatment Adherence and Carver’s brief COPE questionnaires. Results: 1 - 3 months post-PTCA, all dimensions of IP changed significantly except personal and treatment control. Adherence scores decreased simultaneously. With respect to coping mechanisms, all increased except behavioral disengagement, emotional support, instrumental support and religion which decreased significantly post-PTCA. Conclusions: In Overall, an improved IP and increased use of controllable causal attributions led to an increase in medication adherence and adaptive coping strategies. Post-treatment health behaviors are predictable by assessing patients’ illness-related beliefs beforehand.展开更多
Objective: To compare the effect of intracoronary arterial injection of tirofiban and sodium nitroprusside (SNP) on no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) underw...Objective: To compare the effect of intracoronary arterial injection of tirofiban and sodium nitroprusside (SNP) on no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary percutaneous coro-nary intervention (PCI). Methods: A total of 68 patients with acute STEMI who had no-reflow phenomenon during PCI were chosen and randomly divided into SNP group (n = 34) and tirofiban group (n = 34). Aiming at no-reflow phenomenon during PCI, with the use of microcatheters, intracoronary arterial injection of tirofiban was given in tirofiban group, while intracoronary bolus of SNP was given in SNP group. Coronary angiography was conducted to record TIMI flow grade of the infarct-related artery after 10 minutes. Plasma brain natriuretic peptide (BNP) was monitored before and after PCI (in 24 hours). With the help of ultrasound cardiogram, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) were recorded and compared in 30 days after PCI. Results: The ratio of TIMI grade 3 blood flow in tirofiban group was significantly higher than that in SNP group (76.5% (26/34) vs. 52.9% (18/34), p = .03)BNP levels in two groups had no statistical significance before PCI (p = .16), but in 24 h after PCI, BNP levels in tirofiban group were significantly lower than those in SNP group ((439.00 ± 4.90) μmol/L vs. (632.00 ± 3.63) μmol/L, p = .02)In 30 days after PCI, LVEF, LVEDD and LVESD in tirofiban group were all superior to those in SNP group (all p < .05). Conclusions: Intracoronary arterial injection of tirofiban was superior to SNP in improving no-reflow phenomenon in STEMI patients after PCI in the emergency treatment. Tirofiban therapy can increase coronary blood flow and myocardial perfusion after the occurrence of no-reflow phenomenon during PCI in STEMI patients, and improve long-term prognosis.展开更多
文摘Objective To explore how older patients self-manage their coronary heart disease (CHD) aider undergoing elective percutaneous transluminal coronary angioplasty (PTCA). Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients (n = 93) approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings in- formed the purposive samplhag for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualita- tive data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants (n = 47) classified as 65 years of age or older. Results 78.7% (n = 37) of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% (n = 16) thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% (n = 19) would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less (P = 0.02) and smoked less (P = 0.01) than their younger counterparts in the study. Age did not seem to affect PTCA patients' likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption (P = 0.237). Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants' likelihood to alter lifestyle factors.
文摘Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS
文摘Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to assess the clinical profile, angiographic status, and prevalence of restenosis in patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in LMCA. Materials and Methods: This observational cohort study included 17 patients who underwent PTCA in LMCA during one-year study period at tertiary care centers in Government Medical College, Kozhikode, India. Data including various risk factors, clinical and angiographic details, stent used, procedural complications and outcomes including rate of restenosis were analyzed. Results: A total of 17 patients (mean age 53.88 ± 9.80 years) with 76.47% of males were included in the study. Smoking and hypertension were the most common risk factors presented in 52.94% and 47.06% of patients respectively. Single vessel disease (SVD) of LMCA was the most common pattern observed in 47.10%;the rate of restenosis was observed in 11.76% patients. Revascularization was performed in one patient (5.88%) with coronary artery bypass graft and in one patient (5.88%) with PTCA using drug eluting stent (DES). The overall procedural success was 88.24% in this study. Survival rate was 100% at one-year follow-up period. Conclusion: Our study involved patients who underwent PTCA in LMCA, showed smoking as a most prevalent risk factor for coronary artery disease and SVD as a most common pattern, comparatively low rate of restenosis and 100% of survival rate at one-year follow-up period.
文摘Percutoneous transiuminal coronary anginplesty(PTCA)was performed in33 patients of coronary heart diseases(male 30 cases,female 3 cases, meanage 54.2) with Gruentzig’s method.Of all the 33 patients,there were 26narrow parts in 20 cases of the single branch lesions,27 narrow parts in 11cases of the double branch lesions and 11 narrow parts in 2 cases of thethree branch lesions.In 48 branches with lesion vessels,there were 27branches of the left anterior descending coronary arteries (LAD),7 branchesof the left cicumflex coronary arteries(LCX)and 13 branches of the rightcoronaw arteries.The narrow degrees varied from 75% to 100%. The resultswere that,of 33 patients,48 branches of lesion vessels and 64 narrow parts,the successful rates of dilation were 96.9%,87.5%,85.9%,respectively.Ventricular fibrillation occurred in one case during the procedure,whichsoon recovered sinus rhythm through cardioversion.Symptoms of thesuccessful 32 patients were lmproved obviously or diappeared after PATC.Combining with the documents,we think that the successful rates are higherin type A lesion undergoing PTCA.When PTCA for the multiple branchlesions are performed,we ought to master the principle of dilating the mainlessinos in advence.The long-tube lesions were dilated by the long balloonfitting for these lesions.The causes of failure of PTCA in the severe narrowlesions are mainly the the guilding wires or the balloon catheters cann’t passthrough the lesion parts,in addition,the complication problems in PTCA arealso discussed.
文摘Background: Many patients are affected by idiopathicbronchiolitis obliterans organizing pneumonia (BOOP). There are several known causes of BOOP, and several systemic disorders have BOOP as an associated primary pulmonary lesion. Numerous agents including cytotoxic and noncytotoxic drugs have the potential to cause pulmonary toxicity. Descriptions of amiodarone-related BOOP continue to be reported throughout the world. Case Report: We reported a patient with original clinical presentation who developed recurrent sustained ventricular tachycardia (SVT) despite the presence of implantable cardioverter-defibrillator (ICD), hypoxaemia and interstitial pneumonitis in both lung bases. After percutaneous transluminal coronary angioplasty, he developed bronchiolitis obliterans organizing pneumonia (BOOP). Conclusions: To our knowledge, such complications after percutaneous coronary procedure in patients with amiodarone therapy for arrhythmia prophylaxis, are not very frequent in literature.
文摘The purpose of this study was to demonstrate the relation between the transientchanges of electrocardiogram(ECG)on body surface during balloon dilating inpercutaneous transluminal coronary angioplasty(PTCA) and improvement of theresidual myocardial viability after PTCA,Eighteen patients with twenty-threecoronary arteries narrowing above 70% were underwent PTCA and myocardialviability was examined with 99mTc-MIB1 Singlephoton Emission ComputedTomography(SPECT)before and after the procedure.During the balloon dilating30-60s,the ECG with leads Ⅱ,Ⅲ.avF.V4 weve recorded.There were 15 caseswith ECG changes of T wave.ST-Seg-ment and QRS axis(65.2%,47 8% and26.1%.respectively),3 case without ECG chanse.More than 50% change of Twave altitude was scored as 1.ST segment shift(elevation≥lmm or depression≥0.5mm.10mm=lmv)as 2.QRS axis deviation≥15 as 3.Myocardial viabiliiy.was evaluated by SPECT with four-point of nine segments of the left ventricularwall.The integral value of ECG change dung PTCA was closely correlated withthe change value of SPECT(SPECT△)(r=0.74,p【0.01).The sensitivity of themethod was 80%;specificity 100%;the positive predictive value 100%;the negativepredictive value 50%;the accuracy 83.3%.This method was simple,useful and.excellent in evaluating myocardial viability.The rest myocardial viability afterPTCA was higher than it was before PTCA(21.2±3.8 vs 17.6±3.6point,P【0.01).The hibernating myocardial viability was improved post PTCA.
文摘To study the damage effect of percutaneous transfuminalcoronary angioplasty(PTCA)on myocardium,wedetermined the serum CPK and CPK-MB level in 35 casesof patients with coronary henrt disease(CHD)beforePTCA and at 6th,12th,24th hour,2nd,3rd day afterPTCA.The results showed that after PTCA,the serumCPK and CPK-MB in 21 of 35 case of patients wised at12th hour.2nd day reached the peak level.But comparedwith others,it has no significant different(P】0.05).TheCPK and CPK-MB decreased to normal level at 3rd day.Itis suggested that PTCA has no significant damage effect onmyocardium.
文摘Percutancous transluminal coronary angioplasty was pcrfonned in 70patients with high risk characteristics from Jan.1998 toDcc.1997 These factors include age】70(10patients),unstableangina(35patients),ejection fraction【40%(7 patients),multivesseldisease(50patients).There were 96 lesions(79 vessels)dilated,amongthem type Alesion 15,type B lesion 52,type C lesion 29.Autoperfusion balloon was used in 7 patients, coronary stcnl wasimplantcd in 50 paticnts.One patient undcrgoing directional coronaryathrectomy(DCA).The clinical success rate was 91.5% and lesionsuccess rate was 89.6%.Average predilation stenosis was 89.5+8.2%and average postdilation stenosis was 16.9+6.2%.Two patients diedfrom abrupt vessel closureno acule myocardial infarction andemergency coronary bypass operation.The considerations in selectionand management of these high risk patients were discussed. The resultsshowed that PTCA can be performed safely in the complex cases.
文摘Objective:An analysis of 130 cases admitted(during December.1993--December,1997)is reported b.All the patients were treated withprcutnous Transluminal Coronary agioplty (PTCA).In addition to it10 cases underwent a second PTCA because of rt.The totalnumber is 140 cases.Thi paper up the pathlolgic changs ratecharacterized by coronary lesion in type A,B,and C<sub>1</sub> percentage ofvaodilation;rate of success in type A,B,and C<sub>1</sub> and the rate ofrt.Method:Coronary arteriography was performed in most cases add then PTCAwas exercised on selective cases with 7-10 days interval according tothe t plan.Coronary arteriography and PTCA were done synchronouslyin the rest cases.Kissing bicatheter technique were employed in 3cases because of bifurcated lesion and PTCA with insertion of a stntinto the spaces of the coronary artery at a diagonal was applied to 1case.Results:Classification of coronary lesion:Type A 33 cases (23.67%),B57 (40.71%),and C 50 (35.71%).Number of coronary artery:single 40 (2857%),double 59 (42.14%),triple 39 (27.85%),main 2 (1.44%).Vasodilation:LAD 116(74.35%),LCX 22(14.1%),RCA 16(10.25%),Middle 2(1.2%).Rate of success:A 33 (100%),B 57 (94.8%),C 50 (94%).Total rate ofsuccess:95.8% Rate of failure:6 cases(4.2%),of which B 3 and C 3respectively,and one of limited myocardial infarction,one of coronaryabnormality,and others of 99-100% t with one failure of balloonwire to the lesion.Rtsis:10 cases had angina ptori 2-6 monthsafter PTCA and a second PTCA revealed LAD rtnosis,rated 5.7%.Concluon:In this group t lesion (76.42%) was found in Type B andType C,while lesion in Type A was L (23.5%).That’s why highsuccess existed in Type A (100%),while Type B and C with complicatedlesion needed complicated performance and rated low in success (94-94.8%)Vdilation:LAD】LCX】RCA.The rate of success lies in the degree ofcomplicated lesion,balloon wire and selection of catheter.Theinsertion of a tnt into the coronary artery might be the best way totreat PTCA t.
文摘We reported 11 cases of excimer laser coronary angioplasty (ELCA). All were males, the average age being 59.7 years. Five patients had sustained previous myocardial infarctions with post-infarction angina in 2 cases and 6 presented angina only. Coronary angiograms showed stenosis in LAD (N9), LCX(N6) and RCA (N6). According to the ACC/AHA classification, 6 were categorized as type B, and 5 type C. ELCA with adjunctive PTCA were performed in all 8 patients, 1. 3 mm (energy density 14. 5 mJ) and 1.6 mm (energy density 21.0 mJ) laser catheters with 20Hz pulse frequency were used There was one failure and in another ELCA was successful but death followed the procedure. The overall result was laser success 10 out of the 11 cases and procedure success 9.
文摘Objective To prospectively evaluate the safety and therapeutic efficacy ofdalteparin in patients with high risk non-ST- elevation acute coronary syndromes (ACS) during percutaneous coronary intervention (PCI). Methods A total of 175 patients with high risk non-ST-elevation ACS were randomly assigned to 2 groups [dalteparin group and unfractionated heparin (UFH) group]. The patients in dalteparin group were given dalteparin at a dose of 5,000U subcutaneously soon after diagnosis and then an additional 60U/ kg intravenous bolus ofdalteparin before emergent PCI. Vascular access sheaths were removed immediately after PCI or coronary artery angiography; the patients in UFH group were given UFH intravenously at a dose of 25mg just before PCI and an additional 65mg bolus was administered if angiographic findings showed that the patients were suitable for percutaneous transluminal coronary angioplasty (PTCA). Sheaths were removed at 4-6 hours after PCI; Results Eighty-three patients in dalteparin group underwent PCI while 82 patients in UFH group underwent PCI; anti-Xa activities of 52 patients in daltepafin group were measured. The average anti-Xa activity was (0. 83± 0.26) U/ml at 15 minutes after intravenous injection of dalteparin and anti-Xa〉0.SU/ml was obtained in 96.1% of the patients; hematomas at puncture sites were significantly fewer in dalteparin group as compared with UFH group (2.3% vs 9.2%, P 〈 0.05); none of the patients in 2 groups suffered major bleeding events. No death, acute arterial reocclusion or emergent revascularization events occurred at 30 days after PCI. Conclusions Our study demonstrated that early subcutaneous injection ofdalteparin at a dose 5,000U after diagnosis and an additional 60U/kg intravenous bolus ofdalteparin before PCI is safe and efficacious for patients with high risk non-ST-elevation ACS undergoing emergent PCI.
文摘Background and Objective: Coronary artery disease (CAD) is the leading cause of sudden death. In this article, we compared patients’ illness perception (IP), treatment adherence and coping mechanisms of patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Methods: In this descriptive, prospective observational study IP, treatment adherence and coping of 140 patients were evaluated pre-PTCA, at the time of hospital discharge and 1 to 3 months post-PTCA by Illness Perception Questionnaire, Morisky Treatment Adherence and Carver’s brief COPE questionnaires. Results: 1 - 3 months post-PTCA, all dimensions of IP changed significantly except personal and treatment control. Adherence scores decreased simultaneously. With respect to coping mechanisms, all increased except behavioral disengagement, emotional support, instrumental support and religion which decreased significantly post-PTCA. Conclusions: In Overall, an improved IP and increased use of controllable causal attributions led to an increase in medication adherence and adaptive coping strategies. Post-treatment health behaviors are predictable by assessing patients’ illness-related beliefs beforehand.
文摘Objective: To compare the effect of intracoronary arterial injection of tirofiban and sodium nitroprusside (SNP) on no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary percutaneous coro-nary intervention (PCI). Methods: A total of 68 patients with acute STEMI who had no-reflow phenomenon during PCI were chosen and randomly divided into SNP group (n = 34) and tirofiban group (n = 34). Aiming at no-reflow phenomenon during PCI, with the use of microcatheters, intracoronary arterial injection of tirofiban was given in tirofiban group, while intracoronary bolus of SNP was given in SNP group. Coronary angiography was conducted to record TIMI flow grade of the infarct-related artery after 10 minutes. Plasma brain natriuretic peptide (BNP) was monitored before and after PCI (in 24 hours). With the help of ultrasound cardiogram, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) were recorded and compared in 30 days after PCI. Results: The ratio of TIMI grade 3 blood flow in tirofiban group was significantly higher than that in SNP group (76.5% (26/34) vs. 52.9% (18/34), p = .03)BNP levels in two groups had no statistical significance before PCI (p = .16), but in 24 h after PCI, BNP levels in tirofiban group were significantly lower than those in SNP group ((439.00 ± 4.90) μmol/L vs. (632.00 ± 3.63) μmol/L, p = .02)In 30 days after PCI, LVEF, LVEDD and LVESD in tirofiban group were all superior to those in SNP group (all p < .05). Conclusions: Intracoronary arterial injection of tirofiban was superior to SNP in improving no-reflow phenomenon in STEMI patients after PCI in the emergency treatment. Tirofiban therapy can increase coronary blood flow and myocardial perfusion after the occurrence of no-reflow phenomenon during PCI in STEMI patients, and improve long-term prognosis.