Title Perkutane koronarne intervencije transradijalnim putem
Author Vanesa Vujičić
Mentor Alen Ružić (mentor)
Committee member Ivan Bubić (predsjednik povjerenstva)
Committee member Margita Belušić-Gobić (član povjerenstva)
Committee member Srđan Novak (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Internal Medicine) Rijeka
Defense date and country 2016-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract Perkutana koronarna intervencija (PCI) je prvi izbor za dijagnostiku koronarne bolesti i revaskularizaciju značajnih lezija u svim oblicima u kojima se prezentiraju bolesti koronarnih arterija. Budući da je ishemijska bolest srca (IBS) danas glavni uzrok smrtnosti, kako u razvijenim zemljama, tako i u Hrvatskoj, te da je broj PCI u trajnom porastu, pacijentima i stručnjacima je u interesu da odaberu najbolji i najprikladniji način perkutanog pristupa. Zbog relativne jednostavnosti zahvata, niskog postotka komplikacija, te kratkog vremena do ponovno pune mobilizacije nakon zahvata, radijalni pristup je posljednjih godina preuzeo primat pred femoralnim, iako bolesnik u svakoj od opcija mora biti upoznat s mogućim ograničenjima i rizicima metode. Prije svake odluke nužno je procijeniti potencijalni rizik i korist planirane intervencije i to usporediti s rizicima i koristima alternativnih načina liječenja kao što su medikamentno ili kirurško. Današnje indikacije za PCI su vrlo široke i obuhvaćaju spektar bolesnika od asimptomatskih do nestabilnih, s različitim stupnjem ugroženosti miokarda. U samom postupku, odabiru se adekvatni pacijenti, određuje sesmještaj arterija ruke (zbog mogućih anatomskih varijacija) te određuje jesu li prohodne (Allenov test), što je najbitniji uvjet za provođenje zahvata. Zbog velikog rizika za nastanak komplikacija (vazospazma, trombozu...), primjenjuju se pomoćni lijekovi, najviše u vidu antitrombotske i antikoagulantne terapije. Intervencijska kardiologija jedno je od najbrže rastućih područja današnje medicinske znanosti, a tehnološka i farmakološka otkrića unutar tog područja unazad samo nekoliko godina, dovela su do značajnih promjena u liječenju i prognozi bolesnika sa srčanožilnim bolestima.
Abstract (english) Percutaneous coronary intervention (PCI) is the first choice for the diagnosis of coronary artery disease and revascularization of significant lesions in all forms in which coronary artery disease presents. Since today, the ischemic heart disease (IHD) is still the main cause of mortality in developed countries, and also in Croatia, and that the number of PCI procedures is in constant increase, both patients and professionals have the same interest of choosing the best and most appropriate way of percutaneous approach. Because of the relative simplicity of the procedure, the low percentage of complications, and a short time to mobilization after the procedure, the radial approach has become dominant over femoral approach, although patients have to be aware of the possible limitations and risks of both of the methods. Before making any decision, it is necessary to assess potential risks and benefits of the planned interventions and to compare them to alternative treatments such as medical or surgical. Today's indications for PCI are very broad and include patient range from asymptomatic to unstable, with varying degrees of myocardial jeopardy. In the process, the appropriate patients are selected, the location of the arteries of the handis determined (because of the possible anatomic variations) and whether they are viable (Allen test), which is an essential condition for the implementation of the procedure. Because of the high risk of complications (vasospasm, thrombosis ...), extra medications shoud be applied, most in the form of antiplatelet and anticoagulant therapy. Interventional cardiology is one of the fastest growing areas oftoday's medical science, and technological and pharmacological discoveries within the area, only a few years back, have led to significant changes in the treatment and prognosis of patients with cardiovascular disease.
Keywords
perkutana koronarna intervencija
ishemijska bolest srca
revaskularizacija
intervencijska kardiologija
Keywords (english)
percutaneous coronary intervention
ischemic heart disease
revascularization
interventional cardiology
Language croatian
URN:NBN urn:nbn:hr:184:122527
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2016-10-13 09:37:03