The department of Cardiovascular Internal Medicine

A Talk of heart disease, Treatment

Approach to treatment

Removal of risk factor for coronary artery
Diet treatment
High-blood pressure
Quit smoking
Exercise therapy and Stress reduction
Oral treatment
Percutaneous Coronary Intervention
Percutaneous transluminal coronary angioplasty PCI
Percutaneous Transluminal Angioplasty PTA
Coronary Artery Bypass Grafting CABG

Coronary angioplasty PCI;Percutaneous Coronary Intervention

POBA; Plain Old Balloon Angioplasty
POBA; Plain Old Balloon Angioplasty

It is the most basic treatment having been used for over 20 years. The treatment requires local anesthesia only, like contrast study, a catheter is passed through the wrest and the coronary artery is spread out with a balloon.

The treatment is operated from outside of the body by inserting a soft wire into the narrowed section making a path for a balloon to pass through.

Once it has reached the narrowed section, the balloon is swollen to its original size of blood tube. At this time, the pressure applied to dilate is adjusted according to hardness of its pathological lesion. The size of balloon is available in every 0.25mm, and we choose one that is, most suitable to the pathological lesion from balloons with various traits.

At the end of the treatment, we remove everything including the balloon and the wire from the body.
It needs to be performed again 3-6 months or a year after the treatment for therapy evaluation.
* Rate of restenosis: approx.30-40%
* Risk of developing acute coronary occlusion: approx.1-2%
* Coronary dissection can’t be healed.

Coronary angioplasty, Stent placement

Stent placement, Stent

Stent is a new device developed to make up for the weakness of treatment with a balloon, which is a reticulated, stainless-steel intravascular stiffener. The vascular layer ultimately, becomes covered and drawn into the blood tube.
*Rate of restenosis approx.15-20%
*Risk of developing subacute thrombosis, approx. 0.1%

DES;Drug Eluting Stent

In order to prevent in-stent restenosis, the surface is coated with immunosuppressive drug. It causes delay in drawing into the blood tube that, taking Bayaspirin and Panaldine is necessary for at least, 6 months after the treatment.
*Rate of restenosis, less than 5%
*Risk of developing subacute thrombosis, approx. 0.1%
However, the risk increases in emergency cases or where the patient quits taking the medicines.

Other new Devices

DCA;Directional Coronary Atherectomy

It is a treatment that scrapes relatively soft lesions using a blade which spins approx. 2,000 times per minute. A little balloon on the opposite side is used to press the blade against the lesion while scraping.
*Rate of restenosis, approx.30-40%


Scrape the hard lesion with a diamond-encrusted bar by spinning it approx.100,000 to 200,000 times per minute.
*Rate of restenosis, approx.40%
*Since each of the treatments are high in its rate of restenosis, they are used in combination with each other.

CABG;Coronary Artery Bypass Surgery

In recent years, there has been a significant advancement in Coronary Artery Bypass Surgery, enabling a surgery to join original arteries to coronary artery and perform without cardiac arrest. It has decreased risk of complications, caused during cardiac arrest and particularly development of brain infarction after the surgery. Therefore, now, a risk of the graft occluding and shrinking again after connecting it with the great effort.

In our hospital, we respond to emergency CABG with an established system, consisting of 1 full-time cardiovascular surgeon and 4 part-timers.

Actual procedure of Stenting

Stenting for the bifurcation area of lesion
Coarctation caused in the bifurcation area of anterior descending branch and looping branch Extends the stent towards the Looping branch
After that, extends it also towards the anterior descending branch
Extends each stent at the same time

Life after the coronary angioplasty

In hospital room

The time required for resting after the treatment differs depending on which part of the body has undergo the treatment, though, if it is the wrest, you are allowed to walk freely after about 4 hours of rest. You might experience an uncomfortable feeling in the chest right after the treatment but it is to go away within 2 to 3 hours. However, If the pain increases or it starts to hurt again, please immediately inform that to our nursing staff.

Life after leaving the hospital

It requires 2 to 3 days of staying in the hospital. After you leave the hospital, the treatment is continued with oral medicines. If any complications should happen to you, Please contact our staff immediately. In case of stenting treatment, it requires Angiographic examination to check the course of treatment every 6 to 8 months after the first treatment has been performed.

Diet and Exercise therapy

In order to prevent the progression of Arterial sclerosis, it is necessary to exercise appropriately and keep away from smoking, along with management of high blood pressure, diabetes, hyperlipidemia and appropriate exercises.