Journal of Yeungnam Medical Science

Original article

Cardiology and Cardiovascular Medicine
The performance of ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome: the ASFREE prospective pilot study: Donghyeon Joo, Sungho Jo, Jeong Tae Byoun, Jae Young Cho, Kyeong Ho Yun; J Yeungnam Med Sci. 2026;43:25. Published online March 19, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.25

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Abstract PDF: Background
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS); however, bleeding risk remains a major concern. Early discontinuation of aspirin due to potent P2Y12 inhibition may mitigate bleeding without increasing thrombotic events.
Methods
The ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome (ASFREE) study was an investigator-initiated, single-center, prospective, open-label, single-arm pilot study enrolling patients with ACS who underwent PCI with drug-eluting stents. All patients received a single loading dose of aspirin on the day of the PCI, followed by ticagrelor or prasugrel monotherapy. The primary efficacy endpoint was target vessel failure (TVF) at 12 months. The primary safety endpoint was definite stent thrombosis. Event rates are reported with 95% confidence intervals (CIs).
Results
In total, 228 patients were enrolled. TVF occurred in 10 patients (4.4%; 95% CI, 2.1%–7.9%). Definite stent thrombosis was observed in one patient (0.4%; 95% CI, 0.01%–2.4%), with no acute or subacute events. Major bleeding (Bleeding Academic Research Consortium type 3 or 5) occurred in two patients (0.9%; 95% CI, 0.1%–3.1%).
Conclusion
An aspirin-free strategy following a single loading dose with continuation of potent P2Y12 inhibitor monotherapy was feasible in patients with ACS undergoing PCI and was associated with low rates of thrombotic and major bleeding events. These findings should be regarded as hypothesis-generating and supporting further evaluations in adequately powered randomized controlled trials (CRIS registration: KCT0008182).

Case Report

Cardiology and Cardiovascular Medicine
Successful transradial intervention via a radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter: Shin-Eui Yoon, Sangwook Park, Sung Gyun Ahn; Yeungnam Univ J Med. 2018;35(1):94-98. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.94

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2 Crossref

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.

Citations

Citations to this article as recorded by

Safety profile of trans-radial approach (TRA) in patients with radial artery loop in neurointervention: retrospective analysis of a TRA-dedicated neurovascular center experience over 4 years
Wei Cao, Rongguo Hu, Si Zhao Tang, Dandan Jia, Deyuan Zhu, Dayong Qi, Kangqing Zhang, Tonghui Song, Yibin Fang
Journal of Clinical Neuroscience.2025; 139: 111400. CrossRef
Minimizing Guidewire Unwilling Passage and Related Perforation During Transradial Procedures: Prevention Is Better Than Cure
Lili Xu, Jiatian Cao, Meng Zhang, Hongbo Yang, Zheyong Huang, Yanan Song, Chenguang Li, Yuxiang Dai, Kang Yao, Xiangfei Wang, Feng Zhang, Juying Qian, Junbo Ge
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef

Original Article

Cardiology and Cardiovascular Medicine
Long-term clinical outcome of acute myocardial infarction according to the early revascularization method: a comparison of primary percutaneous coronary interventions and fibrinolysis followed by routine invasive treatment: Hyang Ki Min, Ji Young Park, Jae Woong Choi, Sung Kee Ryu, Seunghwan Kim, Chang Sup Song, Dong Shin Kim, Chi Woo Song, Se Jong Kim, Young Bin Kim; Yeungnam Univ J Med. 2017;34(2):191-199. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.191

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Abstract PDF: BACKGROUND
This study was conducted to provide a comparison between the clinical outcomes of primary percutaneous coronary intervention (PCI) and that of fibrinolysis followed by routine invasive treatment in ST elevation myocardial infarction (STEMI). METHODS: A total of 184 consecutive STEMI patients who underwent primary PCI or fibrinolysis followed by a routine invasive therapy were enrolled from 2004 to 2011, and their major adverse cardiovascular events (MACEs) were compared. RESULTS: Among the 184 patients, 146 patients received primary PCI and 38 patients received fibrinolysis. The baseline clinical characteristics were similar between both groups, except for triglyceride level (68.1±66.62 vs. 141.6±154.3 mg/dL, p=0.007) and high density lipoprotein level (44.6±10.3 vs. 39.5±8.1 mg/dL, p=0.005). The initial creatine kinase-MB level was higher in the primary PCI group (71.5±114.2 vs. 35.9±59.9 ng/mL, p=0.010). The proportion of pre-thrombolysis in MI 0 to 2 flow lesions (92.9% vs. 73.0%, p < 0.001) was higher and glycoprotein IIb/IIIa inhibitors were administered more frequently in the primary PCI group. There was no difference in the 12-month clinical outcomes, including all-cause mortality (9.9% vs. 8.8%, p=0.896), cardiac death (7.8% vs. 5.9%, p=0.845), non-fatal MI (1.4% vs. 2.9%, p=0.539), target lesion revascularization (5.7% vs. 2.9%, p=0.517), and stroke (0% vs. 0%). The MACEs free survival rate was similar for both groups (odds ratio, 0.792; 95% confidence interval, 0.317–1.980; p=0.618). The clinical outcome of thrombolysis was not inferior, even when compared with primary PCI performed within 90 minutes. CONCLUSION: Early fibrinolysis with optimal antiplatelet and antithrombotic therapy followed by appropriate invasive procedure would be a comparable alternative to treatment of MI, especially in cases of shorter-symptom-to-door time.

Review Article

Thoracic and Cardiovascular Surgery
Hybrid Coronary Revascularization: Sung Sae Han; Yeungnam Univ J Med. 2007;24(2 Suppl):S36-48. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S36

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Abstract PDF: Hybrid coronary revascularization combines left internal mammary artery (LIMA) to left anterior descending artery (LAD) grafting integrated with percutaneous coronary intervention (PCI) on stenoses in the non-LAD territories. Hybrid coronary revascularization offers multivessel revascularization with minimal morbidity in high risk patients. Usually hybrid coronary revascularization performs minimally invasive direct coronary artery bypass grafting (MIDCAB) without cardiopulmonary bypass. The concept is now 10 year old. This procedure has been developed from MIDCAB plus percutaneous transluminal coronary angioplasty (PTCA) to totally endoscopic coronary artery bypass grafting (TECAB) procedures plus PTCA and drug-eluting stenting (DES). The hybrid coronary revascularization procedure may be especially useful in complex LAD lesions, restenotic lesions in LAD, acute myocardial infarction in “non-LAD” territory, high-risk elderly patients with multiple comorbidities and patients with severe left ventricular systolic dysfunction who are not ideal candidates for conventional bypass surgery. Hybrid coronary revascularization results according to the literature are very attractive. LIMA patency rates were found to be in the 98% range and restenosis rates in the PCI part of the procedure are in a 12% range.¹⁶⁾ The wider introduction of hybrid revascularization is limited chiefly by the high number of repeat interventions compared with off-pump coronary artery bypass grafting, which occurs because of the target vessel failure rate of percutaneous coronary intervention. Drug-eluting stents substantially decrease the reintervention rate. However, the future role of hybrid coronary revascularization is unclear in patients with multivessel coronary artery disease involving the LAD if comparable results may be attained with multivessel PCI.

Case Report

Cardiology and Cardiovascular Medicine
Guide wire fracture during percutaneous coronary intervention.: Hak Ro Kim, Tae Hoon Yim, Byung Chul Kim, Ho Jun Lee, Hong Geun Oh, Hyun Sik Ju, Tae Jin Kim, Young Bok Kim; Yeungnam Univ J Med. 2016;33(1):52-55.; DOI: https://doi.org/10.12701/yujm.2016.33.1.52

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Abstract PDF: Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.

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