简介：Surgicaloptionsdevelopedtotreatcarotidarterystenosishaveevolvedinthelastsixdecades,andstudieshaveshownthesuperiorityofcarotidendarterectomy(CEA)comparedtomedicaltherapy.Similarly,asendovasculartherapyhasevolvedoverthelasttwodecades,studiesreflectingsafety,feasibility,andequivalenceofcarotidarterystenting(CAS)toCEAhavebeenreplicatedinseveralstudiesforintermediatetohighsurgicalriskpatients.However,sinceitsinception,thefieldofCAShasbeenmiredinseveralcontroversiesandhasbeensubjecttointensescrutinyfrommultiplestakeholderswithinthefieldofmedicine.ThisreviewdiscussesspecificissuesconcerningCASthatarerelevantinthecurrentera.

简介：ObjectivesToinvestigatesafetyandeffectivityofpotassiuminpreventionofrestenosisafterPTCA.MethodsEightypatientswithPTCAwererandomizedintotwogroups:Controlgroup(GroupⅡn=40)withconventionaltherapy;Treatmentgroup(GroupⅠn=40)withconventionaltherapyplusoralpotassium(Slow-K1.2g,q8h,given3daysbeforePTCAandcontinuedtotheendofsub-study).Observationindecesoftwogroupswerecomparedinfollow-up.ResultsSeventy-sevenpatientswerefollowed-up(39ingroupⅠ,38ingroupⅡ)Allbloodindices(includingfat,sugar,uricacid,cretonne,Na+,Cl-,Ca2+,Mg2+)exceptbloodpotassiuminbothgroupsweresimilar.Oralpotassiumcouldincreasebloodpotassiumlevelabout0.3mmol/LingroupⅠwithoutcausinganysideeffects.SuspiciousanginapectorisandevidenceofmyocardialischemiabyETTweredevelopedingroupⅡhad14patients(28.9%)andGroupIhad7patients(17.9%);6of17patients(35.3%)ingroupⅠand11of21patients

简介：OjbectiveTofindtheindependentpredictorsforrestenosisaftercoronarystenting.MethodsQuantitativeangiographywasperformedon60cases(67successfullydilatedlesions)afterangio-plastyover6-monthsfollow-up,andbothunivariateandmultivariatelogisticregressionanalysisweredonetoi-dentifythecorrelationsofrestenosiswithclinicalfactors.ResultsThetotalrestenosisratewas31.3%(21of67lesions),andaccordingtounivariateanalysisthepatientswhounderwentcoronarystenting≥3.5mmhadalowerrateofrestenosis(P<0.01).Collateralcirculationtotheobstructionsite,highmaximalinflationpressure,smokingandthelessminimallumendiameterafterPTCAmadetherateofrestenosishigherower(P<0.05).Multivariatelogisticregressionanalysisshowedthatcoronarystenting≥3.5mmhadalowrateofrestenosis,buthighmaximalinflationpressureandsmokingmadetherestenosisratehigher.ConclusionCoronarystentsize,maximalinflationpressureand.smokin

简介：Theoptimaldurationofdualantiplatelettherapy(DAPT)ofaspirinandaP2Y12receptorblockerafterstentingisstillbeingdebated.ThecurrentrecommendationsforDAPTdurationaresignificantlyfocusedonreducingstentthrombosis;alessfrequenteventwithlaterthanearliergenerationdrugelutingstents(DES).ApersistentoccurrenceoflateandverylatestentthrombosiswithfirstgenerationDESsupportedextendeduseofDAPTbeyondoneyear.However,recentstudieshavedemonstratedthatextendeddurationDAPTisassociatedwithincreasedbleeding;anindependentpredictorforpooroutcomes,includinglong-termmortality.Second-generationDESareassociatedwithlesslateandverylatestentthrombosis.SomerecentstudieshavesupportedashorterdurationofDAPTforsecondgenerationDES.However,thesestudieswereinadequatelypoweredtoassesssignificantdifferencesinstentthrombosis.Furthermore,extendeddurationDAPThasbeenassociatedwithareducedriskofthromboticeventsinnon-culpritvesselsinadditiontostentthrombosisinpatientswithacutecoronarysyndromes(ACS).ThehigherriskofbleedingassociatedwithextendedDAPTtherapyprovidesastrongrationaleforpersonalizedDAPTbasedonpatientriskfactors(e.g.ACSvs.non-ACS),typeofstents,andcost-benefitanalyses.

简介：目的：探讨经皮冠状动脉内血管成形术口CA）术后冠脉再狭窄临床治疗效果。方法：已进行过至少一次PTCA，临床和冠脉造影有再狭窄证据的患者，设定第一观察终点为冠脉造影再狭窄（定义为狭窄率超过管腔内径的50％），第二观察终点为死亡。结果：所有PTCA术后血流均达到TIMI3级，残余狭窄在30％以下，无发生严重并发症。结论：使用药物涂层支架或改进的支架和改进的球囊配合药物治疗PTCA术后再狭窄可以大大降低再狭窄的发生率。

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简介：Wepresentthreecasesofself-expandablemetallicstent（SEMS）placementusingaballoonenteroscope（BE）anditsovertube（OT）formalignantobstructionofsurgicallyreconstructedintestine.ABEiseffectivefortheinsertionofanendoscopeintothedeepbowel.However,SEMSplacementisimpossiblethroughtheworkingchannel,becausetheworkingchannelofBEistoosmallandtoolongforthestentdevice.Therefore,weusedatechniqueinwhichtheBEisinsertedasfarasthestenoticarea;thereafter,theBEisremoved,leavingonlytheOT,andthenthestentisplacedbyinsertingthestentdevicethroughtheOT.Inthepresentthreecases,amodificationofthistechniqueresultedinthesuccessfulplacementoftheSEMSforobstructionofsurgicallyreconstructedintestine,andtheprocedureswereperformedwithoutseriouscomplications.Weconsiderthatthepresentprocedureisextremelyeffectiveasapalliativetreatmentfordistalbowelstenosis,suchasinthesurgicallyreconstructedintestine.

简介：ObjectiveTofurtherimprovetherateofreperfusionofinfarctionrelatedarteryinAMI,removethestricture,rescueischemicmyocardium,protectcardiacfunctionandamelioratethelong-termprognosis.MethodAmong73patientswithA-MI,50underwentdirectPICA,15immediatePICA,8rescuePTCAand20braceswereimplanted.ResultTheproportionofrecanalizationis94.5%(69/73).Thegradeofbloodflow(TIMI)improvedtograde3in20patientswithbraceimplantation,while44tograde3and5tograde2among49patientswithsimplePTCA.Residualstenosisinvesselwas1.8±5.9(-10-10)%inpatientswithbraceimplantationversus15.4±11.(0-30)%withsimplePTCA.Theincidenceofreperfusivecardiacarrythmiawas18.1%(10/62).Therewasmainlyfrequentventricularprematurebeatandshortparoxysmalventriculartachycardia,ifleftanteriordecendingbranchwasreopened,whilebradycardiaandatrialventricularblockusuallyoccurredafterrightcoronaryreperfused.ConclusionEmergencyP

简介：BackgroundTheimpactofincompleterevascularization(IR)onadverseoutcomesafterpercutaneouscoronaryinterventionremainsinconclusive,andfewstudieshaveexaminedmortalityduringfollow-upslongerthan5years.TheobjectiveofthisstudyistotestthehypothesisthatIRisassociatedwithhigherriskoflong-term(8-year)mortalityafterstentingformultivesselcoronarydisease.MethodsandResultsAtotalof13016patientswithmultivesseldiseasewhohadundergonestentingpro-cedureswithbaremetalstentsin1999to2000wereidentifiedintheNewYorkState'sPercutaneousCoronaryInterventionReportingSystem.Alogisticregressionmodelwasfittopredicttheprobabilityofachievingcompleterevascularization(CR)inthesepatientsusingbaselineriskfactors;then,theCRpatientswerematchedtotheIRpatientswithsimilarlikelihoodsofachievingCR.Eachpatient'svitalstatuswasfollowedthrough2007usingtheNationalDeathIndex,andthedifferenceinlong-termmortalitybetweenIRandCRwascompared.ItwasfoundthatCRwasachievedin29.2%(3803)ofthepatients.Forthe3803pair-matchedpatients,therespective8-yearsurvivalrateswere80.8%and78.5%forCRandIR(P=0.04),respectively.TheriskofdeathwasmarginallysignificantlyhigherforIR(hazardratio=1.12;95%confidenceinterval,1.01-1.26,P=0.04).The95%bootstrapconfidenceintervalforthehazardratiowas0.98to1.32.ConclusionsIRmaybeassociatedwithhigherriskoflong-termmortalityafterstentingwithBMSinpatientswithmultivesseldisease.Moreprospectivestudiesareneededtofurthertestthisassociation.

简介：摘要目的探讨PTCA术后迷走反射的观察及护理措施。方法回顾性分析17例PTCA术后并发迷走反射患者的临床手术及护理资料。结果迷走反射可发生于术中及术后的各个环节，原因有心理护理不充分、疼痛及排尿紧张等原因所致。结论PTCA术后迷走反射是严重而危险的并发症，唯有认识你发生的原因才能更好的护理，从而避免并发症出现。

简介：摘要目的探讨急诊PTCA加支架植入手术中的配合。方法通过积极的术前准备，加强术中的监测及护理。结果16例患者手术过程顺利，无严重并发症。结论术前积极地准备和术中良好配合及严密监测是急诊PTCA手术成功、减少并发症发生的保障。

简介：经皮冠状动脉成形术（PTCA）已成为冠心病、心绞痛及心肌梗死治疗的重要手段，这项技术的开展对护理工作提出了更高的要求，近年来心脏介入的护理研究取得了相当大的进展，已贯穿手术的全过程并强调受术患者的心理调护，突出了整体化护理的特点，临床实践表明心理护理是整个治疗过程的重要环节与手术成功和并发症的防治休戚相关。

简介：摘要目的通过实施康复护理，有针对的进行观察和护理，促进AMI患者康复，减少及避免AMI的复发率。方法对200例AMI行PTCA+支架术后患者全面实施饮食康复、排泄康复、活动康复、药物康复、行为方式康复、心理康复，分析与其相关的因素及实施后的效果。结果200例ＡＭＩ行PTCA+支架术后患者均获得满意效果。结论200例患者进行康复护理未发生任何护理并发症及AMI的复发,患者掌握了心脏健康相关知识，提高了患者的远期生活质量。

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简介：AbstractIntroduction:Early intervention in patients with congenitally disconnected pulmonary artery improves long-term outcome.Case presentation:We present 3 cases of isolated disconnected pulmonary artery in the absence of associated structural heart disease during a period of 3 years.Conclusion:Transcatheter stenting of the feeding ductus arteriosus re-established pulmonary artery flow and growth. Successful surgical repair was achieved, and normal perfusion and complete function of the ipsilateral lung were regained.

简介：摘要目的进一步探讨介入护师在急性心肌梗死PTCA+支架植入术中的手术配合，以及手术中各种护理操作技术。结果选择手术病例189例，手术成功率97.5%。全组病人无护理差错出现。结论急性心肌梗塞介入手术成功与否与介入护理工作有密切关系。

简介：摘要目的探讨心脏康复护理对冠脉介入患者术后疗效的影响。方法将接受心脏冠脉介入治疗的患者130例按照半随机化原则分为对照组、试验组各65例。2组均采用心脏内科常规护理，试验组在此基础上实施心脏康复护理，观察2组患者住院期间并发症、满意度及随访后的再入院、重要心血管事件发生情况。结果试验组患者住院期间的并发症较对照组低，同时其护理满意度优于对照组（P＜0.05）；1年后随访结果提示试验组的再入院、重要心血管事件均低于对照组（P＜0.05）。结论心脏康复护理具有提高PTCA术后患者近期及远期疗效的作用。

简介：摘要：急性心肌梗塞（AMI）属于常见心血管病，是医院急诊科、心血管内科中较高发的疾病。据流行病学调查统计，该病的整体发病率呈现上升趋势，且和以往相较农村的发病率明显提升，且多发于45岁以上群体中。PTCA凭借其成功率高、疗效好且快等优势近年来被广泛应用，也常被用于治疗AMI患者中。为减少并发症而导致的病死率，为患者落实完善的围术期护理意义重大。本次总结国内外研究，剖析AMI患者在接受PTCA治疗中的护理配合要点，综述如下。

简介：AbstractIntroduction:Obstructed total anomalous pulmonary venous connection (TAPVC) is one of the commonest seen emergencies in pediatric cardiology centers.Case presentation:Our case was diagnosed to have this anomaly, showing early respiratory distress resulting from severe pulmonary congestion. Palliative stenting of the obstruction was done, which helped in stabilizing the debilitated hemodynamics of the baby before surgery, thus a good surgical outcome and prognosis are expected.Conclusion:This intervention may be listed as a vital measurement in the preoperative cardiac stabilization plan for infants with obstructed TAPVC.