Cardiovascular Outcomes of Redo-coronary Artery Bypass Graft Versus Percutaneous Coronary Intervention of Index Bypass Grafts Among Acute Coronary Syndrome: Regression Matched National Cohort Study

Faisaluddin, Mohammed; Sattar, Yasar; Manasrah, Nouraldeen; Patel, Neel; Taha, Amro; Takla, Andrew; Ahmed, Asmaa; Osama, Mohamed; Titus, Anoop; Hamza, Mohammad; Patel, Harsh; Thakkar, Samarth; Syed, Moinuddin; Almas, Talal

doi:10.1016/j.cpcardiol.2022.101580

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…One patient in TUA arm had transient ulnar nerve paresthesia with no residual manifestation at the time of discharge suggesting that damage to ulnar nerve is uncommon and a reversible adverse event of UA cannulation (12) . In meta-analysis held by Faisaluddin et al (6) , a very recent study, a total of 4,796 patients in 8 studies were included in this analysis (TUA = 2,420 [50.4%] and TRA = 2,376 [49.6%]). TUA had higher crossover rate (OR 1.80, 95% confidence interval 1.04 to 3.11, I2 = 75.37%, p = 0.04) than did TRA.…”

Section: Discussionmentioning

confidence: 99%

“…When the TRA is contraindicated for a patient, the TUA provides a secure and efficacious alternative for coronary angiography and intervention. Particularly alluring are operators who possess prior experience with this technique, as well as situations involving radial artery variations or small-caliber arteries (6) . This study was intended to compare radial and ulnar approach for percutaneous coronary procedures as regard feasibility, safety, and incidence of complications.…”

Section: Introductionmentioning

confidence: 99%

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Transulnar versus Transradial Approach for Percutaneous Coronary Procedures

Ali,

Elemary,

Hassan

et al. 2024

Benha Medical Journal

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Background: Transradial access (TRA) for percutaneous coronary procedures has become a widely adopted approach, with proven safety and feasibility. However, the trans-ulnar access (TUA) remains a promising alternative. This study aimed to compare radial and ulnar approach for percutaneous coronary procedures as regard feasibility, safety, and incidence of complications. Methods: This cross sectional comparative study was conducted at the Cardiology Department Cath lab of Benha University Hospitals & National Heart Institute. One hundred patients were included, with 50 patients in the TRA group and 50 patients in the TUA group. Inclusion and exclusion criteria were defined. Various clinical and procedural parameters, including access techniques, were meticulously recorded. Hemostasis was achieved with external compression with the TR band. The study assessed immediate post-procedure complications, so after removal of the TR band and before hospital discharge, all patients were examined postprocedure for potential access-site complications, arterial occlusion was examined clinically and by reversed Barbeau test. Results: The study revealed no statistically significant differences between the TRA and TUA groups in terms of patient demographics, procedural success, duration, fluoroscopy time, and procedure type. There were also no significant disparities in the affected vessel and the number of deployed stents. However, there was a statistically significant increase in the percentage of spasm in patients with TRA (24%) compared to TUA (8%). Conversely, patients with TUA experienced a statistically significant increase in the incidence of hematoma (18%) compared to TRA (4%). Conclusion: TRA has emerged as the prevailing method of access for coronary procedures due to its comparable efficacy and elevated safety profile. Both TRA and TUA approaches were considered safe and feasible for percutaneous coronary procedures. On the other hand, in terms of minor complications, arterial spasm and occlusion were more commonly observed with the TRA, so the TUA remains a promising alternative & proved to be noninferior to the TRA for coronary procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transulnar versus Transradial Approach for Percutaneous Coronary Procedures

Ali,

Elemary,

Hassan

et al. 2024

Benha Medical Journal

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“…The CABG operation of the future should aim at being a definitive operation. Over the last decade, the incidence of redo-CABG has decreased significantly [19,20]. This has occurred concomitantly with an increased usage of multiarterial grafting and better PCI techniques [21].…”

Section: Using Multiarterial Graftingmentioning

confidence: 99%

Designing the coronary artery bypass surgery operation of the future

Ruel

2023

Current Opinion in Cardiology

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Purpose of review This article discusses current shortcomings in coronary artery bypass surgery and ways to overcome them. Recent findings Minimally invasive coronary bypass surgery, robotic coronary bypass, and hybrid approaches aim to avoid sternotomy, employ arterial grafts, and minimize the use of cardiopulmonary bypass. Other considerations such as bypass graft validation, the optimization of guideline-directed medical therapy, and the development of coronary surgery specialists are also crucial to further the benefits of coronary artery bypass grafting on future patients. Summary Coronary artery bypass grafting must become less invasive, be better validated, and be carried out with an even higher emphasis on quality, including graft validation and preoperative/postoperative optimization, if it is to remain the best treatment for advanced, severe coronary artery disease.

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“…Due to anatomical alterations, tissue adhesions, and the source of the bridging arteries, secondary thoracotomies for repeat CABG are not often recommended. Therefore, in patients with a susceptible anatomy, percutaneous coronary intervention (PCI) is the preferred revascularization strategy [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and a history of coronary artery bypass grafting (CABG): A nationwide inpatient sample-matched analysis (2016–2019)

Yan,

Ma,

Shi

et al. 2024

Preprint

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Background The role of sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in patients with a history of coronary artery bypass grafting (CABG) remains underexplored. This study aimed to identify sex disparities in in-hospital outcomes after PCI in patients with AMI and a history of CABG. Methods Using the National Inpatient Sample database, we identified patients hospitalized for AMI with a history of CABG who underwent PCI between 2016 and 2019. The primary outcome was in-hospital mortality, and the secondary outcomes were the length of hospital stay and hospitalization costs. 1:1 propensity score matching was used to minimize standardized mean differences of baseline variables and compare in-hospital outcomes. Results In total, 75,185 weighted hospitalizations of patients who underwent PCI were identified, with 25.2% being female patients. Compared with male patients, female patients exhibited elevated risks of in-hospital mortality (3.72% vs. 2.85%, p = 0.0095), longer length of stay (4.64 days vs. 3.96 days, p < 0.001), and higher hospitalization costs ($112,594.43 vs. $107,020.54, p = 0.0019). After propensity score matching, female patients had higher in-hospital mortality rates than male patients (3.81% vs. 2.89%, p = 0.028). Multivariable logistic regression (adjusted odds ratio [aOR]: 1.48; 95% confidence interval [CI]: 1.14–1.92) and propensity score matching (aOR: 1.34; 95% CI: 1.03–1.73) showed a consistently higher risk of in-hospital mortality among female patients than among male patients. Female patients aged >60 years were more vulnerable to in-hospital mortality than were their male counterparts (3.06% vs. 4.15%, p = 0.0003, aOR: 1.55; 95% CI: 1.18–2.04). Conclusions Female patients who underwent PCI for AMI with a history of CABG had a higher in-hospital mortality rate, which was particularly evident among older patients aged >60 years. Therefore, sex- and age-specific investigations and interventions are required to reduce disparities within this high-risk population.

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Cardiovascular Outcomes of Redo-coronary Artery Bypass Graft Versus Percutaneous Coronary Intervention of Index Bypass Grafts Among Acute Coronary Syndrome: Regression Matched National Cohort Study

Cited by 4 publications

References 23 publications

Transulnar versus Transradial Approach for Percutaneous Coronary Procedures

Transulnar versus Transradial Approach for Percutaneous Coronary Procedures

Designing the coronary artery bypass surgery operation of the future

Sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and a history of coronary artery bypass grafting (CABG): A nationwide inpatient sample-matched analysis (2016–2019)

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