Nghiên cứu ứng dụng kỹ thuật can thiệp trong điều trị bệnh nhân có tổn thương động mạch vành tại Bệnh viện Trung ương Huế

2021 ◽  
Author(s):  
Anh Binh Ho
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Risk Factors ◽  
Percutaneous Coronary Interventions ◽  
Central Hospital ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Artery Disease

TÓM TẮT Mục đích: Can thiệp động mạch vành là một phương pháp có hiệu quả cao trong điều trị bệnh động mạch vành trên thế giới. Tại Huế, kỹ thuật này đã được triển khai từ năm 1998 và được thực hiện một cách thường quy. Chúng tôi tiến hành đề tài này nhằm đánh giá lại hiệu quả của phương pháp can thiệp động mạch vành trên thực tế lâm sàng tại Bệnh viện Trung ương Huế. Phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên đối tượng bệnh nhân được chẩn đoán xác định bệnh động mạch vành và được can thiệp động mạch vành từ tháng 9 - 2010 tới tháng 6 - 2013. Kết quả: Bệnh động mạch vành: tăng huyết áp là yếu tố nguy cơ hàng đầu (56.36%), tiếp theo là rối loạn lipid máu (48.16%) và hút thuốc lá (33.9%). Các bệnh nhân có số yếu tố nguy cơ từ 2 - 4 chiếm đa số: 78.22%. Phần lớn bệnh nhân có tổn tương 1 - 2 mạch máu: chiếm 89.66 %. Tổn thương ĐM Liên thất trước nhiều nhất (67.63%), tiếp theo là ĐMV phải (45.18%) và ĐM Mũ (35.52%). Thấp nhất là tổn thương thân chung (0.86%). Chiều dài trung bình tổn thương ĐM liên thất trước và ĐM vành phải tương đương nhau: 16.98±9.4 mm & 16.05±8.7 mm (p> 0.05) và dài hơn so với ĐM Mũ 13.27±7.01 mm (p<0.05) và ĐM thân chung 9.73±2.77 mm (p< 0.05). Động mạch Liên thất trước được can thiệp nhiều nhất (51.75%), sau đó đến ĐM vành phải (32.53%) và động mạch Mũ (15.02%). Tổng số biến chứng của can thiệp động mạch vành là 2.9%, trong đó tử vong là 0.17%; NMCT là 0.34% và TBMMN là 0.085%. Kết luận: Can thiệp động mạch vành là một phương pháp điều trị có hiệu quả cao đối với bệnh nhân bệnh động mạch vành tại Bệnh viện Trung ương Huế, với tỷ lệ thành công rất cao và biến chứng thấp. Từ khoá: Động mạch vành, can thiệp, biến chứng ABSTRACT THE APPLICATION OF PERCUTANEOUS CORONARY INTERVENTIONS (PCIs) TO TREAT CORONARY ARTERY DISEASE IN HUE CENTRAL HOSPITAL Overview: Percutaneous Coronary Intervention (PCI) is a hightly effective method to treat coronary artery disease all over the world. At Hue, the proceduces have been undertaken since 1998 and now turn to be routine. This study is done to review the effectiveness of PCIs in Hue Central Hospital. Method: Cross-sectional description in patients with coronary artery diseases, who were undertaken percutaneous coronary interventions from September 2010 to June 2013. Results: Coronary risk factors include: Hypertension comes first (56.36%), then hyperlipidemia (48.16%) and smoking (33.9%). Most of patients have 2 to 4 risk factors (78.22%). Lesions on LAD are highest (67.63%), then on RCA (45.18%) and LCx (35.52%). Left main lesions are lowest (0.86%). The mean length leasions of LAD and RCA are equal: 16.98±9.4 mm & 16.05±8.7 mm (p> 0.05) and longer than the mean length leasions of LCx: 13.27±7.01 mm (p<0.05) and LM 9.73±2.77 mm (p< 0.05). PCIs have been undertaken on LAD lesions 51.75%, then RCA lesions 32.53% and LCx lesions15.02%. Total PCIs’complications are of 2.9%, including 0.17% of death, 0.34% of MI and 0.085% of CVA. Conclusion: Percutaneous Coronary Interventions (PCIs) have been undertaken effectively to treat coronary artery disease in Hue Central Hospital, with very high rate of success and very low rate of complication. Key words: Coronary artery disease, Percutaneous Coronary Interventions (PCIs), complication

scholarly journals Intra-Femoral Sheath Time: Does it Increase a Patient's Risk for Developing a Hematoma?

2013 ◽  
Author(s):  
Colleen Planchon
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Femoral Artery ◽  
Percutaneous Coronary Interventions ◽  
Medication Therapy ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
Group A ◽  
Artery Disease ◽  
Group B

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.

scholarly journals The lower the better? Optimal achieved blood pressure for patients with coronary artery disease undergoing percutaneous coronary interventions and kidney failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Yang ◽  
H.B Leu
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Kidney Failure ◽  
Cardiovascular Events ◽  
Chinese Patients ◽  
Percutaneous Coronary Interventions ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Background This study investigates the ideal achieved blood pressure (BP) in ethnic Chinese patients with coronary disease (CAD) and kidney failure (eGFR&lt;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&lt;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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