Effects of acceptance and commitment therapy on self-management skills and psychological resilience of young and middle-aged patients underwent percutaneous transluminal coronary intervention for primary myocardial infarction: a pilot study

Background Acceptance and commitment therapy (ACT) is an intervention focusing on altering how patients relate to their thoughts. This study aimed to investigate the effects of ACT on self-management ability and psychological resilience of young and middle-aged patients undergoing percutaneous transluminal coronary intervention (PCI) for primary myocardial infarction (MI). Methods This pilot study included 98 young and middle-aged patients who underwent PCI for primary MI using a convenient sampling method. The patients were divided into a control group and an ACT group using the random number table method. The patients in the control group received routine nursing, while those in the ACT group received routine nursing combined with ACT. Results The psychological resilience and self-management ability scores were significantly higher in the ACT group than in the control group 3 months after the intervention (P < 0.001 and < 0.05, respectively). In addition, compared to the baseline scores of psychological resilience and self-management ability, these scores were significantly higher in the ACT group at 3 months post-intervention (P < 0.001 and < 0.05, respectively). Conclusion ACT could enhance the psychological resilience and self-efficacy and improve the self-management ability of young and middle-aged patients who underwent PCI for primary MI. Trial registration China Clinical Trial Center ChiCTR2000029775. Registered on 13 February 2020. Registration title:Study on the popularization and application of rotational atherectomy for the treatment of severely calcified coronary lesions.

Stent grafts improved patency of ruptured hemodialysis vascular accesses

This study aimed to compare stent graft with balloon tamponade for ruptured dialysis access during percutaneous transluminal angioplasty. Patients over an 8-year period (2010–2018) were identified from a database of 11,609 procedures. The primary endpoint was target lesion primary patency at 12 months. A total of 143 patients who had rupture dialysis access were enrolled, of whom 52 were salvaged by stent grafts and 91 were salvaged by balloon tamponade. The 6-month target lesion primary patency was greater in the stent graft group than in the balloon tamponade group (66.7% vs. 29.5%, P < 0.001). The benefit of stent grafts was sustained for 12 months (52.5% vs. 9.0%, P < 0.001). The stent grafts increased the median time from the index procedure to the next intervention in the ruptured area by 171 days (260 vs. 89 days) at 12 months. There was no significant difference in the access circuit patency rates at 6 months (25.5% vs. 19.8%, P = 0.203) and 12 months (12.0% vs. 5.8%, P = 0.052). The patency results of the stent grafts remained after the multivariable adjustment analysis. Compared to balloon tamponade alone, stent grafts provided superior target lesion primary patency at 6 and 12 months. The access circuit patency rates were similar.

Tocilizumab and Renal Artery Stent—Therapeutic Strategy for Takayasu Arteritis

Takayasu vasculitis (TAK) is a form of large vessel vasculitis clinically manifesting as pulseless disease or hypertension. It is more common in South East Asia and Japan, India, and Mexico [1]. It is increasingly being recognized due to increased awareness among medical fraternity and better imaging modalities. Undetected hypertension, pulselessness, and syncope are more common symptoms and presentation during pregnancy is unusual and can lead to bad obstetric outcomes. Recent evidences support the use of tocilizumab for inducing remission in Takayasu arteritis. We report this rare case of vasculitis presenting in pregnancy as malignant hypertension. A 20-year-old pregnant woman (45 days) presented with headache and nausea but no fever. She had a history of intermittent claudication of legs for the past 3 years but not evaluated. During examination, pulses were felt normally and blood pressure (BP) 180/110, no murmurs in cardiac auscultation, but she had abdominal bruit (renal vessels). Other systems were normal. Echocardiogram (ECHO) showed dilated ascending aorta. Doppler of renal vessels showed narrowing of renal arteries. Unfortunately, she had to undergo termination of pregnancy (high BP in spite of antihypertensives). Her computed tomography (CT) angiogram showed features of TAK with type 5 pattern–she had methylprednisolone infusion 500 mg daily for 3 days, followed by injection tocilizumab 400 mg monthly 3 doses. Once remission was achieved, she had recanalization by percutaneous transluminal angioplasty of right renal artery. She is currently maintained on aspirin and telmisartan. Awareness of causes of high BP, inputs by radiologist, cardiologist, and rheumatologist and understanding by the patient and family helped to achieve good outcome albeit the miscarriage.

Results of activities of the department of vascular surgery amidst COVID-19 pandemic

Aim. To conduct comparative analysis of the activities of the department of vascular surgery before and during the spread of new coronavirus infection COVID-19 (SARS-CoV-2).Methods. The analysis was performed on the number of outpatient visits of vascular surgeon for types of diagnosis, number and type of surgeries performed at the inpatient facilities of the LLC “Grand Medica” over 2019 (whole year) and 2020 (quarterly).Results. Significant decrease was noted in the number of visits of patients with cardiovascular diseases to vascular surgeon in the outpatient facility. The number of surgeries on limb arteries in patients among Kuzbass residents decreased by 26.4 %, among residents of other regions – by 59.5 %; in brachiocephalic arteries – by 12.5 % and 54.5 %, respectively. The number of percutaneous transluminal coronary angioplasty (PTCA) in patients among Kuzbass residents increased by 25.3 %, among residents of other regions remained unchanged.Conclusion. Decrease in the volume of provision of care for patients with cardiovascular diseases over 2–4 quarters of 2020 is caused by two groups of factors. The first one is associated directly to the epidemiological situation and countermeasures against the spread of SARS-CoV-2 while the second one is associated indirectly.

English Case report: Succesfully Management of Critical Pulmonary Stenosis in a 12-Month-Old Boy By percutaneous transluminal balloon valvuloplasty

Critical pulmonary stenosis (PS) is used in infants born with very severe narrowing valves and requires treatment soon after birth. At four months old, an A-12-month-old boy was diagnosed with critical pulmonary stenosis but still successfully managed by percutaneous transluminal balloon valvuloplasty (PTBV) with satisfactory results without serious complications. Since he was born, cyanosis was seen at his lips and fingertip, with oxygen saturation around 60% until 70%. Echocardiography showed critical pulmonary stenosis, atrial septal defect (ASD), and patent ductus arteriosus (PDA). Percutaneous transluminal balloon valvuloplasty (PTBV) is accepted as the treatment of choice for critical pulmonary valve stenosis in many centers worldwide with significant results. After PTBV, he experienced improvement condition as no cyanosis was observed and oxygen saturation was 96%. This case was our first PTBV intervention case in our hospital and gave satisfactory results, although the intervention was delayed due to our limited resources before. Keywords: cyanosis, critical pulmonary stenosis, percutaneous transluminal balloon valvuloplasty

Percutaneous Transluminal Angioplasty in Chronic Total Subclavian Venous Stenosis Using Coronary Guidewire: A Case Report

Arteriovenous fistula is the best permanent vascular access for hemodialysis (HD). However, in our country, HD catheter in jugular or subclavian vein is more commonly found because our patients prefer to hold HD until the complications are unbearable. The catheter increases risk of venous stenosis on site and in surrounding vessels, resulting in access loss. Percutaneous transluminal angioplasty (PTA), combined with stent deployment, can be utilized as main treatment for such stenosis in subclavian vein. This method dated back to two decades ago with high success rate. Nevertheless, reports or studies of angioplasty in total occlusion are scarce, mainly because of lower success rate and the need of smaller penetrating wire. We describe our experience in performing PTA and stent deployment using coronary wire to penetrate total occlusion in subclavian venous stenosis after vein cannulation. We hope that we can give an alternative technique to avoid surgery in such cases.