scholarly journals Iterative Improvement and Marginal Gains in Coronary Revascularisation: Is Robot-assisted Percutaneous Coronary Intervention the New Hope?

2020 ◽  
Vol 15 ◽  
Author(s):  
Kalpa De Silva ◽  
Aung Myat ◽  
Julian Strange ◽  
Giora Weisz
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Paradigm Shift ◽  
Coronary Intervention ◽  
Coronary Revascularisation ◽  
Current Position ◽  
Robot Assisted ◽  
Percutaneous Coronary ◽  
Future Potential ◽  
Iterative Improvement ◽  
And Training

Percutaneous coronary intervention (PCI) has undergone a rapid and adaptive evolution since its introduction into clinical practice more than 40 years ago. It is the most common mode of coronary revascularisation in use, with the scope, breadth and constellation of disease being treated increasing markedly over time. This has principally been driven by improvements in technology, engineering and training in the field, which has facilitated more complex PCI procedures to be undertaken safely. Robot-assisted PCI represents the next paradigm shift in contemporary PCI practice. It has the ability to enhance procedural accuracy for the patient while improving radiation safety and ergonomics for the operator. This state-of-the-art review outlines the current position and future potential of robot-assisted PCI.

scholarly journals Novel Dual Therapy: A Paradigm Shift in Anticoagulation in Patients of Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

TH Open ◽  
2020 ◽  
Vol 04 (04) ◽  
pp. e332-e343
Author(s):  
Akshyaya Pradhan ◽  
Monika Bhandari ◽  
Pravesh Vishwakarma ◽  
Rishi Sethi
Keyword(s):  
Atrial Fibrillation ◽  
Percutaneous Coronary Intervention ◽  
Triple Therapy ◽  
Antiplatelet Therapy ◽  
Paradigm Shift ◽  
Oral Anticoagulants ◽  
Dual Therapy ◽  
Coronary Intervention ◽  
Bleeding Events ◽  
Percutaneous Coronary

AbstractPatients with atrial fibrillation (AF) on long-term oral anticoagulation (OAC) either have underlying coronary artery disease or suffer from acute coronary syndromes necessitating a percutaneous coronary intervention (PCI). In such a scenario, an amalgamation of antiplatelet and antithrombotic therapy (conventionally called as “triple therapy”) is obligatory for preventing coronary ischemia and stroke. But such ischemic benefits are accrued at the cost of increased bleeding. We also now know that bleeding events following PCI are related to increased mortality. Balancing the bleeding and ischemic risks is often a clinical dilemma. With the advent of novel oral anticoagulants (NOAC's) with preserved efficacy and attenuated bleeding rates, anticoagulation in AF is undergoing paradigm shift. The spotlight is now shifting from conventional triple therapy (vitamin-K antagonist + dual antiplatelet therapy [VKA + DAPT]) to novel dual therapy (NOAC + single antiplatelet therapy [SAPT]) in situation of anticoagulated AF patients undergoing PCI. Such a strategy aims to ameliorate the higher bleeding risk with conventional VKA's while retaining the ischemic benefits. In this review, we briefly discuss the need for combination therapy, trials of novel dual therapy, strategies for mitigating bleeding, the current guidelines, and the future perspectives in AF undergoing PCI with stent(s).

Effectiveness of Micro-class Mobile Teaching Video Method Combined with Psycho-cardiology Nursing in Postoperative Nursing for Coronary Heart Disease Patients Underwent Percutaneous Coronary Intervention and Training

2021 ◽  
Vol 7 (5) ◽  
pp. 4021-4032
Author(s):  
Tong Li ◽  
Qianli Sun ◽  
Qiyue Cui
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Control Group ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
Teaching Video ◽  
Experimental Group ◽  
And Training

Objective. To explore the effectiveness of micro-class mobile teaching video method combined with psycho-cardiology nursing in postoperative nursing for coronary heart disease (CHD) patients underwent percutaneous coronary intervention (PCI) and training. Methods. The clinical information of 120 patients underwent PCI admitted to our hospital (12.2018-12.2020) were retrospectively analyzed, and the patients were divided into the control group and the experimental group, with 60 cases each. Psycho-cardiology nursing was performed to the control group, and the micro-class mobile teaching video method was introduced to the experimental group on this basis to compare the application effect on postoperative nursing and training. Results. After nursing intervention, LVEF levels and ADL scores of both groups were increased, of which the experimental group were much higher (P all<0.05); the BNP levels and SAQ, HAMA and HAMD scores of both groups were decreased, of which the experimental group were much lower (P all<0.05); the problem-solving ability and satisfaction scores of the experimental group were higher than those of the control group (P<0.05); and the experimental group obtained a significantly lower incidence rate of adverse cardiac events in the between-group comparison (16.67% vs 3.33%, P<0.05). Conclusion. The combined therapy conducted to CHD patients underwent PCI has a good effect in postoperative nursing and training, can improve the patients’ cardiac function, reduce the angina severity, alleviate the anxiety and depression, promote the quality of life and problem-solving ability, and lower the incidence rate of adverse cardiac events, which is worthy of promotion and application.

scholarly journals Functionally Complete Coronary Revascularisation in Patients Presenting with ST-elevation MI and Multivessel Coronary Artery Disease

2021 ◽  
Vol 16 ◽  
Author(s):  
Luigi Di Serafino ◽  
Fabio Magliulo ◽  
Giovanni Esposito
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Coronary Revascularisation ◽  
Randomised Trials ◽  
Multivessel Coronary Artery Disease ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Artery Disease ◽  
The Right

Up to half of patients undergoing primary percutaneous coronary intervention of a culprit stenosis in the context of the ST-elevation MI may present with multivessel disease. The presence of non-culprit stenoses have been shown to affect the outcomes of these patients, and the results of the more recent randomised trials highlight the importance of complete coronary revascularisation. In this paper, the authors review the main trials published on the topic and discuss tools for the assessment of non-culprit stenoses, while considering the right time for carrying out a complete coronary revascularisation.

Sign in / Sign up

Export Citation Format

Share Document