Digital Subtraction Angiography Image Features under the Deep Learning Algorithm in Cardiovascular Interventional Treatment and Nursing for Vascular Restenosis.

The objective of this study was to explore the application value of digital subtraction angiography (DSA) images optimized by deep learning algorithms in vascular restenosis patients undergoing cardiovascular intervention and their nursing efficacy. In this study, a network model for removing artifacts was constructed based on a deep algorithm. 60 patients with coronary artery restenosis were selected as the research objects, and they were randomly divided into the CTA group guided by CT angiography (CTA) and digital subtraction angiography (DSA) group, with 30 cases in each group. The antiartifact network model constructed based on the depth algorithm was applied to the images of CTA and DSA for experiments. After cardiovascular intervention and clinical pathway nursing intervention, it was found that the diameter stenosis rate in the DSA group decreased from 65.82 ± 12.9% to 4.7 ± 1.3%, and the area stenosis rate decreased from 88.4 ± 14.3% to 5.4 ± 1.7%. During the follow-up period of 3-24 months, 3 out of 46 lesions in the DSA group showed restenosis, so the restenosis rate was 6.5%, which was significantly lower than the 18.4% in the CTA group (P < 0.05). In the DSA group, there was 1 case of bleeding, 0 case of hematoma, 2 cases of urinary retention, and 0 case of hypotension, so the total incidence of adverse reactions was 10%, which was significantly lower than the 30% of the CTA group (P < 0.05). The high-sensitivity C-reactive protein (hs-CRP) levels of the two groups of patients were 3.58 ± 2.02 mg/L and 4.36 ± 3.11 mg/L before surgery and 3.49 ± 2.18 mg/L and 4.57 ± 3.4 mg/L after the surgery. The postoperative hs-CRP level in the CTA group was slightly lower than that before the surgery and the postoperative hs-CRP level in the DSA group was slightly higher than that before the surgery, but they were not statistically significant (P > 0.05). The hs-CRP level of the DSA group before and after the surgery was slightly higher than that of the CTA group, but there was no significant difference (P > 0.05). In summary, the network model based on the deep learning algorithm can remove the artifacts in DSA images and present high-quality clear images, and convolutional neural network (CNN) algorithms had a strong ability to automatically learn features in the field of medical image processing and were worthy of being widely used and popularized. In addition, the DSA-guided intervention can reduce the rate of vascular stenosis in patients, showing low probability of postoperative restenosis and adverse reactions and a good clinical effect.

Meta-analysis of long-term outcomes of drug-eluting stent implantations for chronic total coronary occlusions.

BACKGROUND: In the treatment of chronic total occlusions (CTOs), some uncertainty exists regarding the effect of drug-eluting stents (DESs) compared with the effects of bare mental stents (BMSs). We reviewed outcomes of DES vs. BMS implantation for CTO lesions, to evaluate the risk-benefit ratio of DES implantation. METHODS: Relevant studies of long-term clinical outcomes or angiographic outcomes of both BMS and DES implantation were examined. The primary endpoint comprised major adverse cardiovascular events (MACEs), including all-cause deaths, myocardial infarctions (MIs), and target lesion revascularizations (TLRs). A fixed-effect model and random-effect model were used to analyze the pooling results. RESULTS: Ten studies were included according to the selection criteria. Eight were nonrandomized controlled trials, and two consisted of a randomized controlled comparison between DES and BMS implantation. No significant difference was evident for in-hospital MACE rates between the two groups (odds ratio [OR], 1.07; 95% confidence interval [CI], .53 to 2.13), but the long-term MACE rates in the DES group were significantly lower than in the BMS group (OR, .22; 95% CI, .13 to .38; P < .00001). The rates of stent restenosis and reocclusions were also significantly lower in the DES group (OR, .14; 95% CI, .09 to .20; and OR, .23; 95% CI, .12 to .41, respectively). CONCLUSION: Implantation of the DES improves long-term angiographic and clinical outcomes compared with BMS in the treatment of CTO lesions.

Coronary revascularisation in chronic kidney disease. Part 1: stable coronary artery disease.

Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease, myocardial infarction and cardiovascular death. Detection and treatment of coronary artery disease in CKD patients has been hampered by the limitations of screening tests, the lack of direct evidence for therapeutic interventions in this specific population, and concerns about therapy-related adverse effects. However, these patients potentially have much to gain from conventional strategies used in the general population. This review summarises the current evidence regarding the treatment of coronary artery disease in patients with CKD, with the focus on coronary revascularisation by percutaneous coronary intervention or coronary artery bypass grafting.

Angina following percutaneous coronary intervention: in-stent restenosis.

Percutaneous coronary intervention (PCI) represents a technical advance in the treatment of coronary artery disease. However, it is not without risks both during and after the procedure. In-stent restenosis (ISR) is the most common complication following PCI. Individuals who experience angina associated with ISR often fail to recognize its seriousness and, therefore, do not respond appropriately to the situation. Individuals with ISR are vulnerable to the consequences of angina, including increased morbidity and mortality, as well as a decreased health-related quality of life. In this article, the authors review the risks for developing ISR, the pathophysiology of angina related to ISR, and the challenges that face patients who develop recurrent angina post-PCI. Cardiovascular nurses play a critical role in the clinical management and education of patients following PCI. The provision of post-PCI follow-up care is key to identifying, managing, and supporting patients with recurrent angina.

Understanding stereotactic radiosurgery for intracranial tumors, seed implants for prostate cancer, and intravascular brachytherapy for cardiac restenosis.

Our 21st century has moved us into a world of technology never imagined. The aim of our article is to move oncology nurses beyond the realm of external beam radiation therapy. We chose to present 3 modalities of high precision that are infiltrating the everyday world of radiation therapy. Stereotactic radiosurgery for intracranial brain tumors and brachytherapy for prostate cancer require an expanded knowledge base for nursing to deliver excellent patient care. Cardiac patients receiving radiation seeds is new in the world of oncology nursing. These patients are unique but they are now a part of our world. Expanding our knowledge base to include a radiation procedure in cardiac care does bring us beyond the world of external beam radiation. Patients often seek information from nurses. Having an understanding of the basic principles and techniques will enable oncology nurses to educate patients. The purpose of this article is to explain the procedure of stereotactic radiosurgery, brachytherapy for prostate cancer, and intravascular brachytherapy for cardiac restenosis. Our discussion will include selection criteria, potential sides effects and risks, and nursing care.