scholarly journals Optical Coherence Tomography: Current Applications for the Assessment of Coronary Artery Disease and Guidance of Percutaneous Coronary Interventions

2020 ◽  
Vol 9 (2) ◽  
pp. 307-321
Author(s):  
Timo T. M. Oosterveer ◽  
Sander M. van der Meer ◽  
Roderick W. C. Scherptong ◽  
J. Wouter Jukema
2013 ◽  
Author(s):  
Colleen Planchon

Despite advancements in technology and medication therapy, coronary artery disease continues to remain the number one cause of death. Treatment for coronary artery disease requires life style modifications, medication therapy, percutaneous coronary interventions, and sometimes coronary artery bypass surgery. Though percutaneous coronary interventions are considered safe and are commonly occurring procedures, there are still risks for complications. One of the most frequently occurring complications is hematoma of the femoral artery site. The purpose of this study was to determine if there was an increased incidence of hematomas in individuals undergoing percutaneous coronary intervention with associated sheath times of less than five hours (Group A) as compared to sheath time of greater than five hours (Group B). The study used a retrospective, two group design and was conducted at a tertiary care center that performs over 1500 PCI’s annually. Inclusion criteria included adults over the age of 18 who were hemodynamically stable, had no known bleeding disorders, and were punctured once at the femoral artery to perform the percutaneous intervention. Two hundred fifty medical records were reviewed utilizing a data collection tool designed by the researcher. Total sample size was 55, 21 in Group A and 34 in Group B. Six hematomas were documented as occurring, but were not reportable based on the ACC definition. Hematomas were documented in the medical record using the terms “small”, “medium,” and “large” versus an objective measurement. No hematomas were identified using the ACC definition, which was the measurement standard for this research hospital. Sheath times in Group A averaged 4.02 hours, and group B 7.42 hours. There was a higher incidence of descriptive hematoma that did not meet the criteria of this study in Group B. Results call for recommendations of on-going documentation of post procedure hematomas using a standardized, reliable, and valid measuring tool. APRN’s can be instrumental in implementing change in patient care , hospital policy and on the national level by assuring that hematomas are accurately and consistently documented. Further research is indicated related to sheath times and potential associated negative outcomes.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Yang ◽  
H.B Leu

Abstract Background This study investigates the ideal achieved blood pressure (BP) in ethnic Chinese patients with coronary disease (CAD) and kidney failure (eGFR<15 ml/min/1.73m2). Methods A total of 575 kidney failure patients who had undergone percutaneous coronary interventions (PCI) were enrolled and divided into 6 to 4 groups according to blood pressure range were analyzed. The clinic outcomes included major cardiovascular events (MACE) and MACE plus hospitalization for congestive heart failure (Total CV event). Results The mean systolic BP was 135.02±24.73 mmHg and diastolic BP was 70.74±13.05 mmHg. Systolic BP 140–149mmHg and diastolic BP 80–89mmHg had lowest MACE/CV event incidence rate (11%/23%; 13.2%/21.1%) compare to other groups. Patients with systolic BP<120mmHg had a higher risk MACE (HR: 2.014; 95% CI: 1.172–3.462, p=0.008) when compared to those with systolic BP 140–149 mmHg. Patients with systolic BP≥160mmHg (HR: 1.838; 95% CI, 3.266–1.035, p=0.038). And diastolic blood BP ≥90mmHg (HR: 2.191; 95% CI: 1.147–4.188, p=0.018) had a higher risk of total cardiovascular events when compared to those with systolic BP 140–149 mmHg and diastolic BP 80–89 mmHg. Conclusions A J-shaped BP association of systolic (140–149 mmHg) and diastolic (80–89 mmHg) was found with decreased cardiovascular events for coronary artery disease with kidney failure after undergoing PCI in non-western population. Funding Acknowledgement Type of funding source: None


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