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모든 경동맥 스텐트 삽입술 시행시 필터형 원위부 색전 보호 기구 사용의 시술 적합성 및 초기 임상 성적
안계택,이재환,김대현,김제,안문상,박재형,박형서,김은미,장원일,김민수,정일순,김규섭,최시완,정진옥,성인환 대한심장학회 2008 Korean Circulation Journal Vol.38 No.12
Background and Objectives: Distal filter devices (DFDs) are known to reduce the occurrence of embolic events by capturing embolic debris and thereby preventing intracranial embolization during carotid artery stenting (CAS). However, there are few reports addressing DFD use in CAS procedures. Therefore, we evaluated the technical feasibility and clinical outcomes associated with DFD use in all CAS procedures. Subjects and Methods: Between June 2004 and June 2008, all CAS procedures performed at our center were completed with DFD protection. We recorded periprocedural data and watched for new neurologic abnormalities for 24 hours after the procedure. Onemonth clinical outcomes were also evaluated. Results: A total of 100 carotid lesions in 94 patients (age 68±8 years; 79 men) were treated with percutaneous stenting using DFDs (FilterWire EZTM, Boston Scientific Co, US). DFD application was successful in all procedures. Periprocedural strokes occurred in five procedures (one major, one minor, and three transient ischemic attacks). The one-month rates of stroke and death were 6% and 2%, respectively. Difficult filter placement occurred in two procedures due to tight stenosis and severe common carotid artery (CCA)-to-internal carotid artery (ICA) angulation. Difficult stent delivery occurred in three instances: one due to severe lesion calcification and two due to proximal tortuosity. The retriever failed to acquire the filter in nine procedures. Four of nine retrieval difficulties were related to severe CCA-ICA angulation. Conclusion: DFD use was successful in all CAS procedures, was relatively safe, and had few periprocedural complications. Background and Objectives: Distal filter devices (DFDs) are known to reduce the occurrence of embolic events by capturing embolic debris and thereby preventing intracranial embolization during carotid artery stenting (CAS). However, there are few reports addressing DFD use in CAS procedures. Therefore, we evaluated the technical feasibility and clinical outcomes associated with DFD use in all CAS procedures. Subjects and Methods: Between June 2004 and June 2008, all CAS procedures performed at our center were completed with DFD protection. We recorded periprocedural data and watched for new neurologic abnormalities for 24 hours after the procedure. Onemonth clinical outcomes were also evaluated. Results: A total of 100 carotid lesions in 94 patients (age 68±8 years; 79 men) were treated with percutaneous stenting using DFDs (FilterWire EZTM, Boston Scientific Co, US). DFD application was successful in all procedures. Periprocedural strokes occurred in five procedures (one major, one minor, and three transient ischemic attacks). The one-month rates of stroke and death were 6% and 2%, respectively. Difficult filter placement occurred in two procedures due to tight stenosis and severe common carotid artery (CCA)-to-internal carotid artery (ICA) angulation. Difficult stent delivery occurred in three instances: one due to severe lesion calcification and two due to proximal tortuosity. The retriever failed to acquire the filter in nine procedures. Four of nine retrieval difficulties were related to severe CCA-ICA angulation. Conclusion: DFD use was successful in all CAS procedures, was relatively safe, and had few periprocedural complications.
안계택,이영달,최웅림,진선아,박수진,김준형,박재형,이재환,최시완,정진옥 한국심초음파학회 2013 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.21 No.2
A subaortic membrane is an uncommon cause for left ventricular outflow tract obstruction. Hypertrophic cardiomyopathy with dynamic left ventricular outflow tract obstruction would mask the presence of the subaortic membrane on transthoracic echocardiography and cause a false diagnosis. We report a patient with subaortic stenosis due to flail subaortic membrane misdiagnosed as obstructive hypertrophic cardiomyopathy on transthoracic echocardiography, identified on transesophageal echocardiography and cardiac catheterization.
고혈압의 진단 및 치료: 대한고혈압학회 진료지침을 기반으로
안계택,진선아,정진옥 대한신경과학회 2019 대한신경과학회지 Vol.37 No.2
Since the new hypertension guideline published by the American Heart Association/American College Cardiology/American Society of Hypertension in 2017, the Korean Society of Hypertension and the European Society of Hypertension revised and announced new hypertension guidelines. Also the Korean Society of Hypertension published Korea hypertension fact sheet 2018, including prevalence, awareness, management status of hypertension, and their trends in Korea. Herein, I provide information on diagnosis and treatment of hypertension based on the new guidelines of the Korean Society of Hypertension.
성석우,안계택,김미주,진선아,이상엽,정명호,정진옥,Korea Acute Myocardial Infarction Registry Investigators 전남대학교 의과학연구소 2020 전남의대학술지 Vol.56 No.1
We evaluated whether thrombus aspiration (TA) during primary percutaneous coronary intervention (PCI) reduces adverse clinical outcomes within 30-days and 1-year periods. There is no well-designed, Korean data about the clinical impact of intracoronary TA during primary PCI in patients with ST-segment elevation myocardial infarction (STEMI). From the Korea Acute Myocardial Infarction Registry-National Institute of Health, 3749 patients with STEMI undergoing primary PCI within 12 hours (60.8±12.9 years, 18.7% women) with pre-procedural Thrombolysis in Myocardial Infarction (TIMI) flow 0, 1 in coronary angiography were enrolled between November 2011 and December 2015. The patients were divided into two groups: PCI with TA (n=1630) and PCI alone (n=2119). The primary end-point was major adverse cardiac event (MACE), defined as the composite of cardiovascular death (CVD), recurrent MI and stroke for 30-days and 1-year. TA did not diminish the risk of MACE, all-cause mortality and CVD in all patients during 30-days or 1-year. After performing the propensity score matching, TA also did not reduce the risk of MACE (Hazard ratio (HR) with 95% Confidence Interval (CI):1.187 [0.863-1.633], p value=0.291), all-cause mortality (HR with 95% CI: 1.130 [0.776-1.647], p value=0.523) and CVD (HR with 95% CI: 1.222 [0.778-1.920], p value=0.384) during the 1-year period. In subgroup analysis, there was no benefit of clinical outcomes favoring PCI with TA. In conclusion, primary PCI with TA did not reduce MACE, all-cause mortality or CVD among the Korean patients with STEMI and pre-procedural TIMI flow 0, 1 during the 30-day and 1-year follow ups.
박윤선,박재형,안계택,장원일,박형서,김준형,이재환,최시완,정진옥,성인환 한국심초음파학회 2010 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.18 No.1
Background: Although the modified Simpson’s method is widely used for the assessment of left ventricular ejection fraction (LVEF), it has limitations including relatively high inter- and intra-observer variability and time consuming nature. We want to evaluate whether assessing mitral annular systolic velocity (S’ velocity) by tissue Doppler imaging (TDI) can be used to evaluate LV systolic function with comparing LVEF by three dimensional echocardiography (3DE). Methods: We examined 3DE and TDI studies of patients between January and August 2008. 3DE LVEF was measured by offline commercial computer software EchoPac PC® (GE, Andover, MA, USA). S’ velocity was obtained from the medial side with apical four chamber view by pulsed-wave Doppler with TDI. Results: We included 125 patients (78 males (62.4%), mean age: 57.5±13.0 years). The mean S’ velocity was 7.7±1.9cm/s and the mean LVEF was 57.2±10.4%. The S’ velocity measured by TDI showed a linear correlation with LVEF measured by 3DE (r=0.688, p<0.001). Study patients were divided into two groups according to the presence of LV systolic dysfunction: Group I (normal LVEF), n=102 and Group II (LVEF <50%), n=23. For prediction of significant LV systolic dysfunction by the receiver operating characteristic curve according to S’ velocity, the optimal cutoff value was 6.8 cm/s. At this cutoff value, the sensitivity and specificity were 94.1% and 87%, respectively. Conclusion: In this study, S’ velocity measured by TDI showed a significant correlation with three dimensional LVEF and can be used to detect patients with LV systolic dysfunction.
Right Ventricular Lipomatous Mass and Biventricular Multifocal Fat in a Young Woman: A Case Report
이보람,박재형,안계택,김성수,정진옥,최시완,진선아,이재환 대한영상의학회 2015 대한영상의학회지 Vol.72 No.4
Cardiac lipoma is a rare neoplasm of encapsulated mature adult adipose tissue. It is usually asymptomatic, but it may be related to hemodynamic obstruction depending on its location. We report a typical case of right ventricular lipomatous mass and multifocal fat infiltration of both ventricles, which were detected incidentally in a young woman.
장원일,정진옥,안계택,박형서,박재형,김송수,이재환,최시완,성인환 대한심장학회 2010 Korean Circulation Journal Vol.40 No.5
The Cabrol procedure is one of several techniques used for re-implantation of a coronary artery. After replacement of the ascending aorta and aortic valve using a composite graft, second Dacron tube grafts are used for anastomosis between the ascending aortic graft and the coronary arteries. Ostial stenosis is one of the complications associated with the Cabrol operation. However, there have been no reported cases of acute thrombosis of a Cabrol graft. Here we report a case with acute ST elevation myocardial infarction due to thrombotic total occlusion of a right Cabrol graft-to-right coronary artery (RCA) twelve days after surgery in a patient with Marfan syndrome. He was successfully treated with primary percutaneous coronary intervention (PCI).