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Case Report: STENT DISLODGEDMENT Oktaviono, Yudi Her
Folia Medica Indonesiana Vol. 52 No. 3 (2016): JULY - SEPTEMBER 2016
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (291.049 KB) | DOI: 10.20473/fmi.v52i3.5455

Abstract

Male 61 years old who presented with stable angina since 1 month ago, with Risk factor of CAD: hypertension, Dyslipidemia and heavy smoker. The ECG showed inferior old myocardial infarction. Diagnostic coronary angiography found: bifurcatio lesion at distal LMCA with significant stenosis 60% at the distal LM and 85% at the osteal LCx (Medina score 1-1-0), high D1 and diffuse disease with maximal stenosis 85% at the distal LAD after D2, Significant stenosis 85% at the osteal LCx and CTO at the distal after OM1, diffuse disease with maximal stenosis 85% at the mid RCA. A 6-Fr JR 4.0 guiding catheter (Launcher, Medtronic) was engaged into the right coronary artery ostium via the femoral artery. GW pilot 50 (Hi-Torque Pilot 50) inserted to distal RCA. Perform Balloon support by Saphire II inserted to mid RCA and dilated, after that perform balloon to proximal RCA and dilated. Stent DES Firebird II (Rapamycin) to mid RCA and dilated. Stent BMS Apollo 3.0x36 mm inserted to proximal-mid RCA, overlapping with previous stent, but was loss or dislodged and insert to the guiding catheter. BMS stent was pulled out with small balloon ex stent. GC 6F 4.0 inserted to ascending Aorta and engaged at ostium RCA. BMS stent Arthos PICO 3.0x 34 mm inserted to proximal-mid RCA, overlapping with previous stent and dilated. Final angiography confirmed successful pull out of loss stent and dilation of the RCA.
Case Report: RETROGRADE APPROACH FOR CTO LESIONS: SERIAL CASE Oktaviono, Yudi Her
Folia Medica Indonesiana Vol. 52 No. 4 (2016): OCTOBER - DECEMBER 2016
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.158 KB) | DOI: 10.20473/fmi.v52i4.5479

Abstract

Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. Retrograde chronic total occlusion recanalization has recently become an essential complement to the classic antegrade approach. Retrograde approach through the collateral channel has been recently proposed and has the potential to improve the success rate of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) lession of the coronary arteries. We report several cases of successful CTO recanalization procedure using retrograde approach in Soetomo Hospital.
Thrombocytopenia in a Patient Undergoing Primary Percutaneous Coronary Intervention Oktaviono, Yudi Her; Meuthia, Feranti
Folia Medica Indonesiana Vol. 55 No. 1 (2019): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (225.434 KB) | DOI: 10.20473/fmi.v55i1.24434

Abstract

Thrombocytopenia is a common abnormality in patients presenting with acute coronary syndrome. Baseline thrombocytopenia in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention is associated with early adverse events, related to both ischemia and bleeding. Treatment for acute coronary syndrome usually involves antiplatelet, anticoagulant, antithrombotic therapy, and the performance of percutaneous coronary intervention. The safety of antiplatelet therapy and percutaneous coronary intervention patients who have acute coronary syndrome and thrombocytopenia is unknown, and there are no guidelines or randomized studies that specifically suggest a treatment approach in such patients. One of the institutions in Italy recommends medical and interventional strategy with radialis as first choice for access site, bare metal stent (BMS) implantation, followed by double antiplatelet therapy (DAPT) for one month. After DAPT discontinuation, at least one antiplatelet drug (aspirin) is recommended for life.
Case Report: The Role of Intravascular Ultrasonography in Patients Underwent Percutaneous Coronary Intervention Oktaviono, Yudi Her; Putri, Alisia Yuana
Folia Medica Indonesiana Vol. 55 No. 4 (2019): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (888.406 KB) | DOI: 10.20473/fmi.v55i4.24517

Abstract

Intravascular ultrasonography (IVUS) has an important role as a complimentary diagnostic tool in percutaneous coronary intervention procedure. IVUS provides valuable information regarding coronary vessel lumen and dimension and also plaque burden and its characteristic. The main use of IVUS in PCI is to guide the choose of interventional strategies to optimize stent deployment. Since drug eluting stent (DES) has promised to decrease the incidence in stent restenosis and stent thrombosis than bare metal stent, but neither the suboptimal results nor the complication after stenting with DES is still high. Thus, optimization of stent deployment under IVUS guidance is important in cases to decrease stent failure after PCI procedure, as well as to decrease complication rate after stenting in order to decrease mortality rate caused by coronary artery disease. We present here the use of IVUS guidance in a 43 and 46 year-old man underwent PCI.
Diagnosis dan Terapi Non-farmakologis pada Hipertensi Pandit Bagus Tri Saputra; Ariikah Dyah Lamara; Mahendra Eko Saputra; Rakha Achmad Maulana; Irien Eko Hermawati; Hanang Anugrawan Achmad; Rachmat Ageng Prastowo; Yudi Her Oktaviono
Cermin Dunia Kedokteran Vol 50 No 6 (2023): Edisi CME
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i6.624

Abstract

Pada tahun 2019, hipertensi diderita oleh 1,28 milyar jiwa di seluruh dunia dan diperkirakan terus meningkat setiap tahun. Saat ini, hipertensi masih menjadi salah satu penyebab utama morbiditas dan mortalitas global. Terdapat perubahan paradigma diagnosis hipertensi menjadi lebih direkomendasikan dengan pemeriksaan tekanan darah di luar klinik (out-of-office blood pressure measurement) berupa pemeriksaan tekanan darah ambulatoar (PTDA) jika fasilitas memadai atau pemeriksaan tekanan darah di rumah (PTDR) pada fasilitas lebih terbatas. Manajemen pasien hipertensi berfokus pada kontrol tekanan darah untuk meningkatkan kualitas hidup serta menurunkan angka kecacatan dan kematian dengan terapi farmakologis dan non-farmakologis. Terapi non-farmakologis telah terbukti membantu mengontrol tekanan darah, menurunkan morbiditas dan mortalitas, baik individu hipertensi maupun individu normal.   In 2019, hypertension was suffered by 1.28 billion people worldwide and is expected to increase every year. Hypertension is still one of the main causes of global morbidity and mortality. There is a paradigm shift that diagnosis of hypertension is more recommended by out-of-office blood pressure measurement. Blood pressure measurements outside clinic can be done with ambulatory blood pressure or home blood pressure in limited facilities. Management of hypertensive patients focuses on blood pressure control with pharmacological and non-pharmacological method to improve quality of life, as well as to reduce morbidity and mortality. Non-pharmacological approach has been proven to optimize blood pressure control, to reduce morbidity and mortality in both hypertensive and normal individuals.
Quercetin Stabilizes Atherosclerotic Plaques by Reducing Matrix Metalloproteinase-9 Expression and Enhancing M2 Macrophage Activity in Wistar Rats Ermawan, Romi; Pikir, Budi Susetyo; Mulyanto, Mulyanto; Utomo, Budi; Widjiati, Widjiati; Oktaviono, Yudi Her
The Indonesian Biomedical Journal Vol 17, No 5 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i5.3790

Abstract

BACKGROUND: Quercetin has been shown to alleviate and prevent atherosclerosis. However, its role in stabilizing atherosclerotic plaques to prevent plaque rupture remains unclear. Therefore, this study was conducted to investigate the effects of quercetin on stabilizing atherosclerotic plaques.METHODS: Thirty-two Wistar rats were objected to a high-fat diet, along with an endothelial injury procedure conducted during the second week to create atherosclerotic plaque models. After six weeks, the subjects were randomly assigned to five groups consist of two control groups and three treatment groups treated with different quercetin dosages. Following the treatment, all subjects were euthanized to collect the left common carotid artery. The stability of the atherosclerotic plaques was evaluated by measuring the expression of matrix metalloproteinase-9 (MMP-9) using real-time polymerase chain reaction, assessing the activity of M1 and M2 macrophages along with the M1/M2 ratio using an enzyme-linked immunosorbent assay, and determining the maximum intima thickness through histopathological examination.RESULTS: Quercetin significantly reduced the expression of MMP-9, increased the activity of M2 macrophages, and lowered the M1/M2 ratio at doses of 10 and 50 mg/kg. However, there was no effect on M1 macrophage activity or maximum intima thickness. Path analysis indicated that quercetin primarily enhanced atherosclerotic plaque stability by reducing MMP-9 expression (p<0.001) and subsequently enhancing M2 macrophage activity (p=0.002).CONCLUSION: Quercetin administration significantly decreased the expression of MMP-9, enhanced the activity of M2 macrophages, and lowered the M1/M2 ratio at specific doses. These findings emphasize the significance of quercetin in stabilizing atherosclerotic plaques.KEYWORDS: atherosclerotic plaque, quercetin, stability, Wistar rats