Stratagy and prognosis of managing culprit vessel with two lesions undergoing primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction / 中国介入心脏病学杂志

Objective To asess the primary percutaneous coronary intervention(PPCI) strategies of culprit vessel with two lesions in ST-segment elevation myocardial infarction(STEMI) patients and their prognosis.Methods The study retrospectively reviewed 418 patients with STEMI undergoing PPCI in the General Hospital of Shenyang Military Region from January 1st to June 30th in 2015 and 75 patients were included. According to whether the non-infarct-related lesions(N-IRL) being treated or not,the patients were identified as both IRL and N-IRL being treated(the research group,n=33) or the culprit lesion(or infarct-related lesion,IRL) being treated only(control group,n=42). The endpoint was major adverse cardiocascular event(MACE) which was a composite of death from cardiac causes,nonfatal myocardial infarction,target vessel revascularization(TVR) and hospitalization with angina or heart failure.Results The study endpoint betwwen the two groups showed no statistical differences in MACE(P=0.446). Multivariate Cox regression analysis showed that age, diameter of N-IRL were predictive factors of MACE. When N-IRL located beyond the culprit lesion, the research group showed higher risk of MACE(P=0.022) and TVR(P=0.039).Conclusions The non-infarct-related lesions of patients with STEMI undergoing PPCI may be left for conventional medical treatment. It may be reasonable to choose drug therapy for distal N-IRL and to choose PCI for proximal N-IRL.

Safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL 2) stent in diabetic patients:A Subgroup analysis of the CREDIT Ⅱ and CREDIT Ⅲ trials / 中国介入心脏病学杂志

Objective To invesgate the safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL2) stent in diabetic patients by a subgroup analysis of of the CREDITⅡand CREDIT Ⅲ trials. Methods All patients who were implanted with the EXCEL2 stent were enrolled in the CREDITⅡand CREDIT Ⅲ trials. The primary endpoint was target lesion failure at 24-month, defi ned as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization(TLR). The secondary endpoint was endpoints including all-cause death, all myocardial infarction (MI) or any revascularization.Results A total of 828 patients were included from the patients who were implanted with the EXCEL2 stent in the CREDIT II and CREDIT Ⅲ trials. 24-month follow-up rate was 99.5%. There was no significant difference in the primary endpoint (P>0.05) and event rates of the secondary endpoints(P>0.05) between the diabetic and non-diabetic group, which included all-cause death[diabetics (2.5%)vs.non-diabetics(1.4%),P>0.05],myocardial infarction(MI)(7.5% vs.5.0%,P>0.05),all from of revascularization(5.0% vs.3.9%,P>0.05),and stent thrombosis(0.6% vs.0.4%,P>0.05).Conclusions EXCEL 2 stent met the objective performance goal on effcacy and safety, which can reduce make stent restenosis, target vessel revascularization ,with 160 diabetic cases among them, and stent thrombosis in diabetic patients.

Clinical Characteristics of Coronary Drug-Eluting Stent Fracture: Insights from a Two-Center DES Registry

Stent fracture (SF) has been implicated as a risk factor for in-stent restenosis, but its incidence and clinical characteristics are not well established. Therefore we investigated the conditions associated with stent fracture and its clinical presentation and outcome. Between 2004 and 2007, consecutive cases of SF were collected from the Seoul National University Hospital. Clinical characteristics and outcome of patients with fractured stents were compared with a ten-fold cohort of age and gender matched controls (n = 236). A total of 4,845 patients received percutaneous coronary intervention and 3,315 patients (68.4%) underwent angiographic follow-up. Twenty-eight fractured stents were observed in 24 patients. The incidence of SF was 0.89% for sirolimus-eluting stents (SES) and 0.09% for paclitaxel-eluting stents. Chronic kidney disease, stent implantation in the right coronary artery (RCA), and SES use were independent predictors of drug-eluting stent fracture by multivariate analysis. SF was significantly associated with binary restenosis (11.4% vs 41.7%, P < 0.001) and increased risk of target lesion revascularization (8.1% vs 33.3%, P = 0.001). Patients with SF but without significant restenosis showed excellent outcome despite only medical treatment. In conclusion, SF is associated with increased rates of restenosis and repeat revascularization. Significant risk factors include chronic kidney disease, RCA intervention, and SES use.

Clinical Characteristics of Coronary Drug-Eluting Stent Fracture: Insights from a Two-Center DES Registry

Stent fracture (SF) has been implicated as a risk factor for in-stent restenosis, but its incidence and clinical characteristics are not well established. Therefore we investigated the conditions associated with stent fracture and its clinical presentation and outcome. Between 2004 and 2007, consecutive cases of SF were collected from the Seoul National University Hospital. Clinical characteristics and outcome of patients with fractured stents were compared with a ten-fold cohort of age and gender matched controls (n = 236). A total of 4,845 patients received percutaneous coronary intervention and 3,315 patients (68.4%) underwent angiographic follow-up. Twenty-eight fractured stents were observed in 24 patients. The incidence of SF was 0.89% for sirolimus-eluting stents (SES) and 0.09% for paclitaxel-eluting stents. Chronic kidney disease, stent implantation in the right coronary artery (RCA), and SES use were independent predictors of drug-eluting stent fracture by multivariate analysis. SF was significantly associated with binary restenosis (11.4% vs 41.7%, P < 0.001) and increased risk of target lesion revascularization (8.1% vs 33.3%, P = 0.001). Patients with SF but without significant restenosis showed excellent outcome despite only medical treatment. In conclusion, SF is associated with increased rates of restenosis and repeat revascularization. Significant risk factors include chronic kidney disease, RCA intervention, and SES use.

Nursing care for patients carrying indwelling catheter in target vessel for continuous chemotherapy / 介入放射学杂志

Objective To reduce the occurrence of undesirable catheter-related events in patients with indwelling catheter during the course of continuous chemotherapy.Methods(1)To enhance the propaganda,education and guidance to patients.(2)To standardize the nursing care operations.(3)To establish the reasonable care rules and procedures.(4)The nurses should take the daily nursing care,observations and recording work seriously.Results Through the analysis of a variety of problems occurred in patients with indwelling catheter during the course of continuous chemotherapy the nursing care experience was summed up.Conclusion Proper and effective care can reduce the occurrence of undesirable catheter-related events in patients with indwelling catheter during the course of continuous chemotherapy.

Coronary stenting without predilatation in acute coronary syndromes / 中国介入心脏病学杂志

Objective The aim of this study was to asses the success rate, lesion characteristics and complication in acute coronary syndromes treated by direct coronary stenting Methods 92 patients with acute myocardial infarction and unstable angina were divided into the direct stenting ( n =32) and stent implantation with balloon predilatation (conventional stenting, n =60) groups The clinical data, characteristics of target vessels ,success rate and complications were compared between two groups Results The age in direct stenting groups was much younger than that in conventional stenting group (53 14?9 18 vs, 64 28?12 36, P