Effect of Papaverine on Left Internal Mammary Artery Flow: Topical Spraying versus Perivascular Injection Method

L, Girish Gowda S; V, Jayanth Kumar H; Veeresh, G S; Mathew, Anand; Nanjappa, Manjunath Cholenahally

doi:10.21470/1678-9741-2019-0126

Cited by 7 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They measured the LIMA graft per minute flow before administering papaverine which was not statically different 51.9 and 55.1 ml/m between the groups. They measured the flow again 20 min after papaverine administration and found that graft flow in the perivascular injection group increased with statically significant difference 87.2 and 104.7 ml/m [ 74 ]. To avoid mechanical injury to the intima of ITAs, some researcher believes that perivascular injection of papaverine to the periarterial tissue of the pedicle is a safe and effective alternative to intraluminal and topical papaverine application [ 68 , 75 ].…”

Section: Different Methods Of Papaverine Deliverymentioning

confidence: 99%

All we need to know about internal thoracic artery harvesting and preparation for myocardial revascularization: a systematic review

Masroor

Zhou

Chen

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

Internal thoracic arteries (ITAs) are the gold standard conduits for coronary revascularization because of their long-term patency and anti-atherosclerotic properties. Harvesting and preparation of ITAs for revascularization is a technically demanding procedure with multiple challenges. Over the last few decades, various methods and techniques for ITAs harvesting have been introduced by different surgeons and applied in clinical practice with different results. Harvesting of ITAs in pedicled or skeletonized fashion, with electrocautery or harmonic scalpel, with open or intact pleura, with clipping the end or keeping it perfused; papaverine delivery with intraluminal injection, perivascular injection, injecting into endothoracic fascia, and papaverine topical spray are the different techniques introduced by the number of researchers. At the same time, access to the ITAs for harvesting has also been studied. Access and harvesting through median sternotomy, mini anterolateral thoracotomy, thoracoscopic, and robotic-assisted harvesting of ITAs are the different techniques used in clinical practice. However, the single standard method for harvesting and preparation of ITAs has yet to be determined. In this review article, we aimed to discuss and analyze all these techniques of harvesting and preparing ITAs with the help of literature to find the best way for ITAs harvesting and preparation for myocardial revascularization.

show abstract

Section: Different Methods Of Papaverine Deliverymentioning

confidence: 99%

All we need to know about internal thoracic artery harvesting and preparation for myocardial revascularization: a systematic review

Masroor

Zhou

Chen

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…The greatest increases in blood flow were detected in the groups that were administered papaverine intraluminally and perivascularly. Girish Gowda et al 24 compared two methods of papaverine delivery: topical spray on the harvested LIMA versus perivascular injection. They reported that papaverine delivery using the perivascular injection technique resulted in significantly higher flows in comparison to the topical spray technique.…”

Section: Comparison Of Intraluminal Topical and Perivascular Administ...mentioning

confidence: 99%

“…In a study by Yavuz et al 12 , the injection of papaverine into the periarterial tissues was shown to be safe and efficient in relieving perioperative spasms of the IMA compared with the topical or intraluminal application of papaverine. Gowda et al 24 showed that delivery of papaverine to the LIMA by using the perivascular injection technique revealed significantly greater flows compared with the topical spray technique. Therefore, they suggested that the perivascular delivery of papaverine is more effective than the spray technique in LIMA blood flow improvement.…”

Section: Comparison Of Intraluminal Topical and Perivascular Administ...mentioning

confidence: 99%

Use of papaverine in harvesting internal mammary graft in coronary artery bypass grafting: An update

Jannati

2022

Surgical Practice

View full text Add to dashboard Cite

The left internal mammary artery (LIMA) graft is the main arterial graft that is used in coronary artery bypass grafting (CABG). The spasm of LIMA is a complication that frequently occurs while harvesting the LIMA and may lead to morbidity and mortality in patients after CABG. Clinically, papaverine is the most frequently used vasodilator. In this review, we evaluated the administration of papaverine in IMA grafts during CABG. It was shown that administration of papaverine into the LIMA improves the blood flow and abolishes vasospasm of the LIMA. Moreover, the intraluminal and perivascular administrations of papaverine are more effective than topical administration. Higher concentrations of papaverine should be used with caution because it may lead to endothelial damage.

show abstract

“…İntralüminal uygulama sırasında artan gerilim sonucu intima ve internal elastik lamina hasar görebilir [17,18] . Serbestleştirilmesi öncesinde LIMA etrafına papaverin enjeksiyonu ile gerçekleştirilen perivasküler enjeksiyon yönteminde enjeksiyon yapılırken, henüz cerrahi diseksiyonun tamamlanmamış olması nedeniyle bölgesel anatomiye egemenlik sağlanamamıştır ve LIMA ponksiyonu riski taşımaktadır [19] . Bir başka sorun ise, serbestleştirilmesi öncesinde uygulanan papaverin; yalnızca LIMA ana hattının değil aynı zamanda LIMA yan dallarında da kanlanmayı artırarak kanamaya yol açabilir.…”

Section: öRneklem Büyüklüğü Ve İstatistiksel Analizunclassified

“…Gowda GSL ve ark. [19] Çalışmalarında, uyguladıkları perivasküler papaverin enjeksiyonunu ponksiyon riskini minimalize edebilmek için LIMA serbestleştirilmesinden sonra yapmışlardır. Topikal papaverin uygulamasına göre perivasküler enjeksiyon yönteminde daha yüksek LIMA serbest akımları ölçtüler.…”

Section: öRneklem Büyüklüğü Ve İstatistiksel Analizunclassified

Ultrasound-Guided Transverse Thoracic Muscle Plane Injection vs. Topical Spraying of Papaverine for LIMA Harvesting: A Pilot Study

Aydın¹,

Al²,

Yayık³

et al. 2021

GKDA Derg

View full text Add to dashboard Cite

INTRODUCTION: Although the effect of topical papaverine on the left internal mammary artery (LIMA) flow is a well-known method, papaverine hydro dissection is applied to the transverse thoracic muscle plane is unknown. This study aims to investigate the effect of ultrasound-guided transverse thoracic muscle plane papaverine injection on LIMA flow. METHODS: ASA II-III, 40 patients who underwent coronary artery bypass grafting surgery, were randomly divided into two groups. Group topical papaverine (Group TP, n=20) and Group ultrasound-guided papaverine (Group USP, n=20). In Group TP, 10 mg papaverine in 10 mL saline was administered topically after LIMA harvesting. In Group USP, ultrasound-guided transverse thoracic muscle plane papaverine injection with the same solution preoperatively. Trans-time flow measurements (TTFM), LIMA harvesting time, and surgeon satisfaction were recorded. RESULTS: There was no difference in LIMA free flows before anastomosis between Group USP and Group TP (111.35±69.76 vs. 92.15±46.76, respectively, p=0.185). There was no significant difference between the groups in TTFM values evaluated after anastomosis (p> 0.05). LIMA harvesting time was statistically shorter in Group USP than Group TP (13.90±3.01 vs. 16.65±4.50 respectively, p=0.049). Surgeon LIMA harvest satisfaction was statistically significantly higher in group USP (p=0.029). DISCUSSION AND CONCLUSION: We think that papaverine injection via ultrasound-guided transverse thoracic muscle plane may be an alternative method to topical application to prevent LIMA spasm.

show abstract

Effect of Papaverine on Left Internal Mammary Artery Flow: Topical Spraying versus Perivascular Injection Method

Cited by 7 publications

References 12 publications

All we need to know about internal thoracic artery harvesting and preparation for myocardial revascularization: a systematic review

All we need to know about internal thoracic artery harvesting and preparation for myocardial revascularization: a systematic review

Use of papaverine in harvesting internal mammary graft in coronary artery bypass grafting: An update

Ultrasound-Guided Transverse Thoracic Muscle Plane Injection vs. Topical Spraying of Papaverine for LIMA Harvesting: A Pilot Study

Contact Info

Product

Resources

About