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A Pilot Study about the First Cases of coronary angioplasty in Democratic Republic of Congo/Kinshasa: Patient Profile

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Case Reports in Clinical Medicine 2023年第10期12卷 371-388页

作者： David Ipungu Gondele Eulethère Vita Kintoki Yves Lubenga Georges Ngoyi Trésor Mvunzi Dominique Mupepe Nathan Buila Zéphirin Kamuanga Fahd Qureshi Aliosha Nkodila Jean Robert Rissasi Makulo Jean René M’buyamba-Kabangu Cardiology Unit University of Kinshasa Hospital Kinshasa The Democratic Republic of Congo Cardiology Unit Centre Hospitalier Victor Dupouy Argenteuil France Cardiology Unit H.J. Hospitals Kinshasa The Democratic Republic of Congo Public Health and Familly Medecine Protestant University of Congo Kinshasa The Democratic Republic of Congo Nephrology Unit University of Kinshasa Hospital Kinshasa The Democratic Republic of Congo

Background: The objective of this pilot study was to describe clinical profile, electric, echocardiographic and angiographic caracteristics with procedural outcome of congolease patients undergoing coronarography in the first and only one cardiac catheterization center opened in Kinshasa. Methods: An analytical cross-sectional study was carried out over a period from October 2019 (date of establishment of the first coronary angiography unit in DR Congo) to March 2021. We proceeded to a serial sampling of the consecutive cases of all the patients who have an angiographic exploration of coronary arteries. Clinical, ECG and cardiac ultrasound data were collected in all patients. The indications for the coronary angiography examination were set by differents cardiologists on the basis of repolarization troubles in the electrocardiogram, cinetic troubles in echocardiography, positive stress test and chest pain in patients with cardiovascular risq factors. Results: The serie (47 patients) was predominantly male with a sex ratio M/W of 2.6. The average age was 59.8 ± 10.5 years. Arterial hypertension (HBP) was the main risk factor (89.4%);followed by diabetes mellitus (14.9%). Chest pain was the main functional sign with an atypical character in 44.7%. The ECG showed ST segment depression (17%) and T wave inversion (17%), the anterior region being the most affected. Hypokinesia was the most common echocardiographic abnormality (34%), followed by akinesia (10.6%). The anteroseptal and apical territories were affected in 12.8%. Dilated myocardiopathy (DMC) was significantly predominant in the male sex (29.4% vs 7.7%;p = 0.011). With radial puncture as the main approach, coronary angiography was pathological in 44% revealing mono-truncal lesions. The left coronary network was the most affected: the middle inter ventricular artery (12.8%), the proximal interventricular artery (10.6%) and the proximal circonflex artery (10.6%). In multivariate logistic regression analysis, age

关键词： Heart Disease coronary angioplasty Patient Profile Pilot Study Democratic Republic of Congo

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COMPLEX PERCUTANEOUS TRANSLUMINAL coronary angioplasty

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中国介入心脏病学杂志 1998年第4期6卷 154-154页

作者： Wang Dongqi Wang,Yonping Lan.Changzong Cui First affiliated hospital of Xi’an medical university.Xi’an 710061,China

Percutancous transluminal coronary angioplasty was pcrfonned in 70patients with high risk characteristics from Jan.1998 toDcc.1997 These factors include age>70(10patients),unstableangina(35patients),ejection fractioncoronary stcnl wasimplantcd in 50 *** patient undcrgoing directional coronaryathrectomy(DCA).The clinical success rate was 91.5% and lesionsuccess rate was 89.6%.Average predilation stenosis was 89.5+8.2%and average postdilation stenosis was 16.9+6.2%.Two patients diedfrom abrupt vessel closureno acule myocardial infarction andemergency coronary bypass *** considerations in selectionand management of these high risk patients were discussed. The resultsshowed that PTCA can be performed safely in the complex cases.

关键词： coronary artery lesiorls percutaneous transluminal coronary angioplasty treatement

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Safety and feasibility of repeated percutaneous transradial coronary intervention in the same route

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Chinese Medical Journal 2012年第2期125卷 221-225页

作者： Nie Bin Zhou Yu-jie Yang Qing Cheng Wan-jun Wang Zhi-jian Wang Jian-long Capital Med Univ Beijing Anzhen Hosp Dept Cardiol Beijing 100029 Peoples R China

Background The radial approach has been increasingly used as an alternative to femoral *** more procedures using repeated transradial coronary intervention （r-TRI） are ***,few data about r-TRI has been ***,we investigated the safety and feasibility of r-TRI using the same *** A total of 423 consecutive eligible patients undergoing r-TRI were enrolled in the r-TRI group,and 846 patients with initial TRI （i-TRI） were assigned to the i-TRI group in a 2：1 matching ratio compared to r-TRI *** primary endpoint included the success rate of the procedure and the incidence of vascular related *** The baseline clinical characteristics in the two groups were *** success rate of procedures in the r-TRI and i-TRI was similar （96.0% vs.97.5%,P=0.130）.In subgroup analysis （coronary angiography only or angiography with pecutaneous coronary intervention）,similar results were also *** puncture numbers and incidence of radial artery spasm in the r-TRI group were significantly higher than in the i-TRI group （P=-0.024 and P 〈0.001,respectively）.The other procedural outcomes in the two groups were *** respect to the incidence of overall vascular related complication and independent events,there were no significant differences in spite of a higher incidence of radial artery occlusion （RAO）in the r-TRI group （RAO：1.2% vs.0.7%,P=-0.521）.The patients in the i-TRI group had more comfortable feeling than patients in the r-TRI group （P=-0.001）.Conclusions R-TRI produces a comparable procedure success rate and incidence of vascular complication when compared to *** should be considered as an acceptable and safe procedure.

关键词： transradial approach coronary angioplasty procedure success vascular complications

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Current status and perspective of percutaneous coronary intervention in China

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Chinese Medical Journal 2006年第7期119卷 531-532页

作者： GAO Run-lin Cardiovascular Institute and Fuwai Hospital Chinese Academy ofMedical Sciences Peking Union Medical College Beijing 100037China

The first percutaneous transluminal coronary angioplasty （PTCA） in China was performed in 1984. Since then the progresses in this field have been achieved gradually. The development process can be divided into 3 phases roughly. According to a national survey organized by Chinese Society of Cardiology, from 1984 to 1996, as the first phase, percutaneous coronary intervention （PCI） can only be performed in a few centers by a few cardiologists. By the end of 1996, only 6213 cases of PCI in total were undergone in 51 hospitals nationwide with success rate of 91.9%. The most common procedure was balloon angioplasty. A few cases of directional coronary atherectomy （DCA）, rotational atherectomy and excimer laser angioplasty were performed in very few centers. coronary stenting has been performed since 1992. By 1996, coronary stents were implanted in 51.3% of the patients undergone PCI. From 1997 to 2001,

关键词： coronary intervention coronary angioplasty development process

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ST-elevation myocardial infarction caused by very late stent thrombosis due to drug-eluting stent fracture

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Chinese Medical Journal 2012年第15期125卷 2794-2796页

作者： MA Guo-tian LI Lang WU Xiang-hong Department of Cardiology First Affiliated Hospital GuangxiMedical University Nanning Guangxi 530021 China

Although the incidence of coronary stent fracture （SF） is relatively rare, the increasing amount of patients v undergoing percutaneous indicates more cases coronary- intervention （PCI） of SF. The incidence of sirolimus-eluting stent （SES） fracture is reported in 0.89% to 4.4% of patients at 6 to 12 months follow-up 12 anglography post-PCI. Recently, SF has been recognized as a complication that may result in thrombosis, perforation, restenosis, and migration of the stent resulting in morbidity and mortality. Here we describe a rare case presented with ST-elevation myocardial infarction （STEMI）, which was caused by very late stent thrombosis due to SES fracture, in order to help the physicians ensure rapid recognition and treatment of this urgent situation.

关键词： myocardial infarction drug-eluting stents, fracture coronary angioplasty

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A more than 2-year follow-up of incomplete apposition after drug-eluting stent implantation

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Chinese Medical Journal 2008年第6期121卷 498-502页

作者： QIAN Ju-ying ZHANG Feng FAN Bing GE Lei WANG Qi-bing GE Jun-bo Department of Cardiology Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Diseases Shanghai 200032China

Background Incomplete stent apposition （ISA） has been demonstrated to be more common after drug-eluting stent （DES） implantation than after bare metal stent （BMS） implantation, Clinical outcomes of ISA remain controversial and the predictive accuracy of previous studies was limited by the short follow-up period of only 12-18 months. In the present study, we present the outcomes of a more than 2-year follow-up in patients with ISA after DES implantation, Methods From the clinical and core intravascular ultrasound （IVUS） database of the hospital, we identified 76 patients who had undergone DES implantation in de novo lesions between January 2004 and June 2005 and had received IVUS examination at a scheduled 6-month follow-up. A total of 13 （17.1%） patients had documented I SA at the follow-up by IVUS. Clinical follow-up was available up to 41 months after DES implantation and up to 33 months after identification of ISA, Results Over a mean follow-up of （34：~5） months （range 24-41 months）, 3 of the 13 patients （23.1%） suffered from ST elevated myocardial infarction with one death. Angiography confirmed the very late stent thrombosis （ST） in the area with ISA, All the 3 patients were implanted with sirolimus elulJng stents in left anterior descending artery （LAD） and the very late ST occurred at 29, 31 and 32 months after DES implantation, and separately at 20, 23 and 23 months after the identification of ISA, All of the 3 patients had antiplatelet therapy continued before suffering from ST, and had been apparentJy stable on antiplatelet monotherapy with aspirin for a long peried following dual antiplatelet therapy with aspirin and clopidogrel for more than 12 months. Conclusion ISA of DES may be associated with a high incidence of very late stent thrombosis, even in clinically stable patients with dual antiplatelet therapy of at least 12 months after the procedure.

关键词： drug-eluting stents incomplete stent apposition thrombosis coronary angioplasty

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Wire trapping technique combined with retrograde approach for recanalization of chronic total occlusion

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Chinese Medical Journal 2008年第17期121卷 1753-1756页

作者： GE Jun-bo ZHANG Feng GE Lei QIAN Ju-ying WANG Hao Department of Cardiology Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Diseases Shanghai 200032 China

coronary chronic total occlusion （CTO）, defined as a ,total occlusion of duration 〉3 months, remains a technical challenge for the interventional cardiologists. The major limitation in percutaneous coronary intervention （PCI） of CTO is the inability to penetrate and cross the occlusion with a guidewire. It was reported that the immediate angiographic success rate varied from 50% to 70% using the standard antegrade techniques.1 To improve this suboptimal success rate, the authors firstly introduced retrograde approach through the collateral channels as a novel technique and successfully recanalized a left main CTO using this technique when demonstrating the live cases in Transcatheter Cardiovascular Therapeutics （TCT） 2005. Recently, modified techniques based on the retrograde approach have demonstrated that this approach could provide a high success rate with PCI.3-5 In the present report, we described a new method, wire trapping technique combined with retrograde approach, which was applied successfully in three patients with CTO.

关键词： chronic total occlusion retrograde approach wire trapping coronary angioplasty

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Comparison between primary angioplasty and thrombolytic therapy on erectile dysfunction after acute ST elevation myocardial infarction

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Asian Journal of Andrology 2012年第5期14卷 784-787页

作者： Ramazan Akdemir Ozlem Karakurt Salih Orcan Nihat Karakoyunlu Mustafa Mucahit Balci Levent Sagnak Hamit Ersoy Mehmet Bulent Vatan Harun Kilic Ekrem Yeter Department of Cardiology Faculty of MedicineSakarya UniversitySakarya 54054Turkey Department of Cardiology Batikesir Government HospitalBalikesir 10100Turkey Department of Urology Diskapr Yildinm Beyazpt Research and Education HospitalAnkara 06110Turkey Department of Cardiology Yuksek I htisas Research and EducationAnkara 06590Turkey Department of Cardiology Diskapl Yddtnm Beyazlt Research and Education HospitalAnkara 06110Turkey

Acute ST elevation myocardial infarction has high mortality and morbidity rates. The majority of patients with this condition face erectile dysfunction in addition to other health problems. In this study, we aimed to investigate the effects of two different reperfusion strategies, primary angioplasty and thrombolytic therapy, on the prevalence of erectile dysfunction after acute myocardial infarction. Of the 71 patients matching the selection criteria, 45 were treated with primary coronary angioplasty with stenting, and 26 were treated with thrombolytic agents. Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient＇s sexual function before the acute myocardial infarction and 6 months after the event. The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction. The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group （P= 0.008）. In conclusion, this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence, and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction.

关键词： coronary angioplasty erectile dysfunction fibrinolysis myocardial infarction myocardial reperfusion

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Optical coherence tomography application as guiding in percutaneous coronary intervention procedure one year follow up survey

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South China Journal of Cardiology 2013年第3期14卷 176-183页

作者：罗明华关怀敏解金红陈玉善李兴渊王贺邱承杰沈晓君 Department of Cardiology the First Affiliated Hospital of Henan University of Traditional Chinese Medicine Teaching and Research Section of Pathology Henan University of Traditional Chinese Medicine

Background Optical coherence tomography （OCT） is increasingly used in the process of percutaneous coronary intervention （PCI）, but there is still lack of data about the significance of OCT in the process of PCI. The study aimed to investigate the long term value of OCT in the procedure of PCI. Methods One hundred sixty-five patients with coronary artery disease and implanted drug eluting stents were enrolled in the retrospective study. OCT was performed after stent implantation to detect the complications in 82 patients, who were named as OCT group. And the other 83 patients without OCT application served the control group. Incidence of the angina pectoris, acute myocardial infarction, revascularization and cardiac sudden death was observed in the two groups during one year follow-up. Results At one year clinical follow-up, the incidences of angina and revascularization in OCT group were significantly lower than those in control group （angina： 3.66% vs. 18.07%, P 〈 0.05; revascularization： 2.44% vs. 12.04%, P 〈 0.05）, the incidence of acute myocardial infarction was not significantly different （2.44% vs. 4.82%, P 〉 0.05）. Conclusions OCT is a feasible technique for guidance of coronary interventions, and its application during PCI procedure can improve the clinical outcome.

关键词： optical coherence tomography percutaneous coronary intervention coronary angioplasty stents coronary disease

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CLINICAL APPLICATION OF PERCUTANEOUS BALLOON MITRAL VALVALOPASTY

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中国介入心脏病学杂志 1998年第4期6卷 176-176页

作者： Qing Xian Li Dong Sheng Gao Jia Qi Zhao Affliliated Hospital of Jining Medical College,Jining,Shandong Province,272129,China.

The operation of PBMV is popular and considecl highlybeacuso of advantages of satisfactory effects andlittle *** there are many difficulties inpractices,such as the balloon can’t be passedthrough the mitral valve *** operated 64patients by the method of big curve in front part ofthe catheter during PBMV and all of the catheterswere passed through the mitral valve in short time,the stenosis valves vere dilated *** myopinion,in order to made a big curve in front partof the catheter,it is vital to change the curve infront part of left ventricular wire according to thesize of left atrium,which can make the catheter havea proper curve to pass the mitral *** addition,it is not suitable to puncture the artial ssptum inhigher position,if so,the front part of the catheterin left atrium is parallel or almost parallel to theaitral valve,not in the right angle,so the cathetercan’t be easy to pass through the mitral *** the puncturing,the angle of the punctureneedle must be settled properly to reduce *** suggest that the degrees of arrowin the puncture needle be set to 45°.60 and 75°separately when the size of left atrium are 4.0cm,5.0cm and *** pueeturing in such degree,thecatheter could be in right angle with the mitralvalve and passed through the valve easily.

关键词： coronary artery lesiorls percutaneous transluminal coronary angioplasty treatement

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