coronary angioplasty

Longitudinal stent deformation (LSD) is an infrequent complication of percutaneous coronary intervention. While the occurrence of gross LSD is a rare phenomenon, minor changes in length are common and have been recognized as accepted behavior of stents during implantation. Due to the proximity of the guide catheter, ostial or ostio‑proximal lesions are prone to stent deformation either by the guide or other devices during navigation. Moreover, to satisfy the fractal geometry of coronary bifurcation, the proximal optimization technique is commonly performed during different bifurcation procedures, which can subject the stent to extreme overexpansion resulting in structural deformation. We describe two cases of longitudinal stent elongation during ostial deployment and try to analyze the factors behind this rare, yet complicated behavior of the latest‑generation drug‑eluting stent.

The current registry system aims to design a database that can be used for future research as a tool to produce and update new protocols for the diagnosis, treatment, management, and prevention of heart diseases.  

In this hospital-based registry system, established on 27 July 2021, all the adult patients (age ≥18 years old) with signs and symptoms of cardiac diseases under coronary angiography or angioplasty in the cardiac ward of Imam Hossein Hospital of Tehran, Iran were recruited and followed-up until 30 days after discharge in the pilot phase. All data were collected using a researcher-made checklist from face-to-face interviews with patients and their medical records. The data were registered electronically in web-based software. Quality Control (QC) is conducted monthly by the QC team to ensure the documented data's quality.  

among 1265 patients under coronary angiography or angioplasty over a year, 97% (n=1198) of them were Iranian, and 991 (73.33%) patients lived in the country's capital, Tehran. About 55% (n=706) of patients were male. The mean age of the total patients was 60.48 ± 12.01 years. 764 (60.39%) patients were diagnosed with Coronary Artery Disease (CAD). Of all CAD patients, 32.72% (n=250) and 1.18% (n=9) were premature and very early CAD, respectively. During one year, 22.54% (n=279) and 7.02% (n=87) of patients were under PCI and CABG, respectively.  

Since CVDs, especially CADs, are one of the most common and priority diseases in Iran's health system, establishing a coronary angiography and angioplasty registration system is an opportunity to study the epidemiological and clinical process of CVDs in the shape of an accurate registration system.

Introduction &

 Atherosclerosis is one of the leading causes of cardiovascular disease  and research has shown that regular physical exercise with appropriate intensity and duration It can improve cardiovascular function, especially in patients with atherosclerosis, but little research has been done on the effect of different exercises (aerobic, resistance and strength) on arterial biomechanics (peripheral and central) and there are contradictory results. In addition, few studies have been done on middle-aged people. The main purpose of this study was to evaluate the effect of eight weeks of aerobic training on selected variables bilateral femoral artery biomechanics in middle-aged men, three to seven days after coronary angioplasty. 

 Thirty patients with coronary angioplasty who underwent coronary angioplasty, ranging in age from 45 to 60 years, were randomly selected from the patients referred to the Rehabilitation Clinic of Tehran Cardiac Center. Arterial resting lumen diameter(LD) in systolic and diastolic phases and intima-medial thickness(IMT) of bilateral femoral artery, compliance and ratio of intima-media thickness to lumen diameter(IMT/LD) were measured before and after exercise. The aerobic exercise program was performed for eight weeks and three sessions per week, each session lasting 40 minutes on three devices: treadmills, an arm ergometer and a workhorse, for each patient. In this study, analysis of covariance tests at the significance level of 0.05, paired t-test and Will Coxon test were used. 

 The results showed that aerobic exercise on selected variables of vascular biomechanics [resting lumen diameter in systolic and diastolic phase] , Was confirmed at the significance level of 0.05 and Although the effect of aerobic exercise was not significant in some variables of vascular biomechanics [compliance and ratio of intima-media thickness to lumen diameter] . in some angioplasty patients; But in general, all variables have improved in order to improve and reach the norm of normal people. 

 The present study concluded that aerobic exercise improves the biomechanical condition of the arteries and suggests that performing consistent exercises having is of paramount importance in heart patients to prevent further heart attacksheart patients.

Hypertension is a major global health problem and a risk factor for cardiovascular disease. An unhealthy lifestyle can increase the risk of hypertension and psychological disorders, thereby heightening the risk of cardiovascular disease.

The study aimed to evaluate the effects of lifestyle education on depression, anxiety, stress, and perceived family support among hypertensive patients undergoing coronary angioplasty.

This randomized clinical trial recruited 60 hypertensive patients undergoing angioplasty at the coronary care units of an educational hospital in Isfahan, Iran, in 2015. Then, 30 subjects were randomly allocated to each intervention and control group. The patients in the intervention group and their family members were provided with group lifestyle education in six sessions held in three successive weeks, accompanied by one-month follow-up telephone contacts. Data were collected before, immediately after, and one month after the intervention using a demographic questionnaire, the 21-item Depression, Anxiety, and Stress Scale with Cronbach’s alpha values of 0.80, 0.83, and 0.87, and a researcher-made family support questionnaire. Data analysis was done using the paired-sample t, independent-sample t, chi-square, Mann-Whitney U, and repeated-measures analysis of variance tests.

The study groups did not significantly differ respecting demographic characteristics, and the pretest mean scores of depression, anxiety, stress, and perceived family support (P > 0.05). However, significant between-group differences were observed at both posttests, respecting the mean scores of depression, anxiety, stress, and perceived family support (P < 0.05). Moreover, while these mean scores did not significantly change in the control group (P > 0.05), the mean scores of depression, anxiety, and stress significantly decreased, and the mean score of perceived family support significantly increased in the intervention group across the three measurements (P < 0.05).

Lifestyle education effectively reduced depression, anxiety, and stress and improved perceived family support among patients with hypertension and angioplasty. Nurses can use such interventions to improve patient outcomes.

Considering the important role of cardiac rehabilitation exercises for patients after coronary angioplasty, this study aimed to determine the effect of an eight-week parallel exercise period on hematological variables (red and white blood cells, hemoglobin, and hematocrit) and cardiac function (functional capacity, ejection fraction, and maximum oxygen consumption) in patients aged 40 to 65 years following the coronary angioplasty. 

 In this semi-experimental study with pre-and post-test design, 90 men and women with coronary heart disease who underwent angioplasty, were randomly divided into two experimental groups (aerobic and parallel exercise) and a control group. Using the instructions of ACSM, 40 minutes of aerobic exercise in eight weeks for rehabilitate of heart patients (three times a week) in the aerobic exercise group, and 40 minutes of aerobic exercise (three times a week) and 20 minutes of resistance exercise program (twice a week) in parallel exercise group. The control group had no exercise other than the recommendation of three days of walking during the week. Kruskal-Wallis and Mann-Whitney U tests were implemented to compare pairs of groups in variables with abnormal distribution. In normal variables, the Levin test was used to check the homogeneity of variance of the data. Due to heterogeneity of variance, the Welch test and Tamhane's T2 Post-Hoc test were used for intra- and inter group comparisons at a significance level of 0.05. 

Using parallel exercise, selected hematologic variables (hemoglobin and red blood cells) were significantly increased. Also, selected variables of cardiac function including (maximum oxygen consumption and ejection fraction and functional capacity) through aerobic and parallel exercises in middle-aged patients following coronary angioplasty, showed an increasing trend. The variable of maximum oxygen consumption in the parallel exercise group was significantly higher than the aerobic exercise group. 

 According to findings, the beneficial effects of both regular aerobic and parallel exercises in appropriate intensity and duration with the priority of parallel exercise are recommended to improve hematological variables and cardiac function in patients 40 to 65 years after coronary angioplasty.

With the onset of the coronavirus disease-2019 (COVID-19) pandemic, hospitalization and treatment of non-covid patients decreased worldwide. The aim of this study is to evaluate the admission and treatment of patients with coronary artery diseases (CADs) by examining coronary Cath labs activities in some centers of Iran during the COVID-19 period.

A retrospective, multi-center survey was conducted in four cites in Iran which participated in National Persian Registry Of CardioVascular diseasE (N-PROVE). Two periods of COVID-19 occurrence peak in Iran were compared with the same date in 2019. Information was collected on the number of diagnostic and therapeutic coronary catheterizations in both stable ischemic heart diseases (SIHDs) and acute coronary syndrome (ACS) settings.

In the first peak of COVID-19 pandemic, coronary angiographies and angioplasties decreased by 37 and 38% compared to the same period in 2019, respectively. The most common indication for coronary angiography during this period was ACS [especially ST-Segment Elevation Myocardial Infarction (STEMI)]; however, at the time of peak decrease, the SIHDs were the most. In the second peak of COVID-19 pandemic in Iran, 34% and 27% decrease in diagnostic and therapeutic coronary procedures were seen, respectively. During this period, the number of elective admissions increased, although it was still lower than that in 2019. The tendency to rescue percutaneous coronary intervention increased in most centers during the COVID-19 era, especially in the second peak.

A significant reduction in the coronary Cath lab activity has been observed during the COVID-19 pandemic that can indicate an increased risk of cardiovascular mortality and morbidity.

Poor medication adherence (MA) is a significant concern in patients with cardiovascular disease (CVD) in low and middle-income countries. Thus, understanding the factors affecting this concern is the first step in designing effective interventions in such societies. In this regard, the purpose of this study was to investigate MA in a sample of Iranian patients after coronary angioplasty and to identify prediction factors based on the World Health Organization framework.

This descriptive-correlational research was conducted on 203 patients post carotid artery (CA) who were recruited from the Cardiology Clinics of Tabriz between November 2016 and February 2017. Data were collected based on socio-demographic characteristics and the Persian version of the Morisky Medication Adherence Scale (MMAS), and the Charlson comorbidity index was used as well. Finally, the multiple linear regression method was applied to identify the significant predictors of MA.

The mean (standard deviation) MMAS score was 5.85 (±1.83). A multivariable model (adjusted R2=0.136) predicted adherence using experienced medication side effects (B=-1.094, a 95% confidence interval (CI)= -1.700– -0.489, P<0.001) and having a recall (B=0.658, 95% of CI=0.153-1.163, P=0.011) and hospitalized history due to current disease (B=-0.537, 95% of CI=-1.031–-0.043, P=0.033).

The results of this study provide a better conception of the role of patients’ experiences about medication side effects and the presence of a recall member in the family for MA after angioplasty. Patients’ problems and concerns related to the side effects of medications must be resolved to improve MA.

The feasibility and safety of coronary angiography (CAG) and angioplasty via trans-snuffbox approach (TSA) is still concerned; therefore, in this study, we aimed to assess possible complications occurring after TSA versus trans-radial approach (TRA).

This prospective observational study was undertaken from June 2017 till March 2018. Individuals aged at least 18 years who were admitted for CAG through upper extremity were eligible and categorized to TSA (n = 70) and TRA (n = 56) groups. Occurrence of complications including hematoma, pain or paresthesia, pseudoaneurysm formation, arterial obstruction, limb ischemia, and major adverse cardiovascular events (MACE) including death, myocardial infarction (MI), stroke, and emergency vessel revascularization was assessed after the procedure and in two separate visits three and six months afterwards.

The mean age of participants in TSA and TRA groups was 55.1 ± 9.7 and 56.5 ± 9.6 years, respectively (P = 0.415). Men were the dominant group in both approaches [TSA: 44 (62.8%), TRA: 36 (64.3%), P = 0.868]. Success rates in TSA and TRA were 88.6% and 94.6%, respectively (P = 0.230). Radial artery occlusion (RAO) was reported in two (3.2%) and one (1.8%) case in TRA and TSA, respectively (P = 0.653). MACE incidence was not significantly different in TSA compared with TRA group (1.8% vs. 4.8%, respectively, P = 0.389). There was no major procedural complication, neither in TSA nor in TRA category.

Our results revealed that TSA could be classified as an alternative modality to other common CAG and angioplasty methods due to its high safety rate and lower complications. Several comprehensive population-based studies are necessary for confirming these findings. Keywords: Radial Artery; V

There are some side effects such as the restenosis of the coronary artery resulted from the failure to follow the medication regimen. Considering that patients" beliefs have a great role in their lifestyle, this study aimed at investigating the relationship between beliefs in medication and self-reported medication adherence in patients with coronary angioplasty (CA).

This was a descriptive cross-sectional correlational study. Based on the inclusion criteria, qualified participants were chosen from among the patients who referred to heart specialty hospital using a convenience sampling method. The applied questionnaire in this study included three sections encompassing the demographic information, a 5-item Medication Adherence Questionnaire (MARS), and BMQ-S questionnaire containing two aspects of "necessity" and "concerns about taking medications".

The mean of participants" age was 56.99 (SD=12.80) and the majority of the participants were males (78.7%), married (89.3%), and mostly illiterate (30.7%). The study results showed that 70% (n=105) of the participants had a weak medication adherence. The results of the Pearson correlation demonstrated a statistically significant relationship between the beliefs in medication and adherence to it.

After CA, nurses and family members can pave the way for the patients to adhere to medication by influencing their beliefs

Coronary artery disease (CAD) is one of the most common diseases today. Among the diagnostic methods, angiography is the main and gold standard in the diagnosis Since angiography is an invasive procedure, this procedure complications range widely from minor problems with short term sequelae to life threatening ones may cause irreversible damage or even death.

This paper is a review study and papers published within the period of 2002-2017 were assessed. To obtain related scientific documents, web surfing was conducted in Persian and English using various keywords including angiography, coronary artery disease, angiography complications, patient satisfaction, femoral angiography, radial angiography, ulnar angiography, superficial palmar branch of ulnar artery, and snuff box angiography. Papers related to this subject were extracted from the Web of Science (ISI), PubMed, Magiran, Google Scholar, Elsevier, Ovid, and SID databases.

Out of the 100 retrieved studies, 31 (3 cross sectional, 1 analytical descriptive, 7 descriptive studies, 6 reviews, 2 RCT, 5 Cohorts, 1 Case Report, and 6 Case series) were entered into this study. In addition, 69 records were excluded for wrong statistics reported, duplicate studies, lack of enough information, and lack of relevance to this study.

According to most studies, the procedure via hand for angiography is better than the lower extremity (femoral). In addition, it seems that the use of distal upper extremities for angiography is better than the radial and ulnar method. However, more research evidence is strongly warranted.