Patency When Grafted to Coronary Stenosis More Than 50% in LIMA-RA-Y Grafts

Royse, Alistair; Brennan, A.; Pawanis, Zulfayandi; Canty, David; Royse, Colin

doi:10.1016/j.hlc.2019.09.007

Cited by 10 publications

(3 citation statements)

References 22 publications

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“…Limited and inconsistent evidence exists over the recommended threshold for severe stenosis, but many studies have suggested grafting RA to coronary targets with >70% stenosis [ 71 , 72 , 73 ]. Based on our retrospective review of RA grafts from the mid-1990s, patency rates were higher for RA grafted to coronary stenosis 50–70% than generally reported in the literature [ 74 ]. A relative contraindication to the use of RA conduit would be trans-radial catheterization procedures which may cause morphological and functional impairments, including reduced vessel diameters, vasomotor functions, and structural damages to the wall [ 75 ].…”

Section: Radial Artery Graftingmentioning

confidence: 99%

Late Clinical Outcomes of Total Arterial Revascularization or Multiple Arterial Grafting Compared to Conventional Single Arterial with Saphenous Vein Grafting for Coronary Surgery

Ren

Royse

2023

JCM

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Coronary surgery provides better long-term outcomes than percutaneous coronary intervention. Conventional practice is to use a single arterial conduit supplemented by saphenous vein grafts. The use of multiple arterial revascularization (MAG), or exclusive arterial revascularization (TAR), however, is reported as having improved late survival. Survival is a surrogate for graft failure that may lead to premature death, and improved survival reflects fewer graft failures in the non-conventional strategy groups. The reasons for not using MAG or TAR may be due to perceived technical difficulties, a lack of definitive large-scale randomized evidence, a lack of confidence in arterial conduits, or resources or time constraints. Most people consider radial artery (RA) grafting to be new, with use representing approximately 2–5% worldwide, despite select centers reporting routine use in most patients for decades with improved results. In conclusion, the current body of evidence supports more extensive use of total and multiple arterial revascularization procedures in the absence of contraindications.

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Section: Radial Artery Graftingmentioning

confidence: 99%

Late Clinical Outcomes of Total Arterial Revascularization or Multiple Arterial Grafting Compared to Conventional Single Arterial with Saphenous Vein Grafting for Coronary Surgery

Ren

Royse

2023

JCM

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“…However, grafting nonseverely stenosed coronary vessels may also be associated with increased operative risk and adverse events, such as higher chances of graft occlusion [18][19][20] and the potential to speed up the progression of native CAD [16,17]. This leads us to the next chapter.…”

Section: Andandmentioning

confidence: 99%

“…A recent analysis of 295 composite grafts using the left internal thoracic artery together with an additional artery or vein suggested an almost two-fold increase in graft occlusion rate if the target was a nonseverely compared with a severely stenosed coronary vessel [18]. Royse et al [19] report an 83% increase in occlusion risk for every 10% reduction on native coronary artery stenosis in 346 patients having received LITA-radial composite grafts.…”

Section: Introductionmentioning

confidence: 99%

How to deal with nonsevere stenoses in coronary artery bypass grafting – a critical perspective on competitive flow and surgical precision

Doenst

Sousa‐Uva

2022

Current Opinion in Cardiology

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Purpose of reviewFor invasive treatment of coronary artery disease (CAD), we assess anatomical complexity, analyse surgical risk and make heart-team decisions for percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). With PCI, treating flow-relevant lesions is recommended, and reintervention easily treats disease progression. For CABG, some stenoses may only be borderline or nonsevere despite a clear surgical indication. As reoperations are not easy, the question on how to address these lesions has been around from the start, but has never satisfactorily been answered. Recent findingsWith a new mechanistic perspective, we had suggested that infarct-prevention by surgical collateralization is the main prognostic mechanism of CABG in chronic coronary syndrome. Importantly, the majority of infarctions arise from nonsevere coronary lesions. Thus, surgical collateralization may be a valid treatment option for nonsevere lesions, but graft patency moves more into focus here, because graft patency directly correlates with the severity of coronary stenoses. In addition, CABG may even accelerate native disease progression.

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Total Arterial Revascularization, Techniques, and Results

Lemma¹

2023

Ischemic Heart Disease

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Patency When Grafted to Coronary Stenosis More Than 50% in LIMA-RA-Y Grafts

Cited by 10 publications

References 22 publications

Late Clinical Outcomes of Total Arterial Revascularization or Multiple Arterial Grafting Compared to Conventional Single Arterial with Saphenous Vein Grafting for Coronary Surgery

Late Clinical Outcomes of Total Arterial Revascularization or Multiple Arterial Grafting Compared to Conventional Single Arterial with Saphenous Vein Grafting for Coronary Surgery

How to deal with nonsevere stenoses in coronary artery bypass grafting – a critical perspective on competitive flow and surgical precision

Total Arterial Revascularization, Techniques, and Results

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