Prospective randomized trial of endoscopic vs open radial artery harvest for CABG: Clinical outcome, patient satisfaction, and midterm RA graft patency

Tamim, Muhammed; Alexiou, Christos; Al-Hassan, Donya; Faraidy, Khalid Al

doi:10.1111/jocs.14706

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…When exploring the different techniques used to harvest the RA, a prospective randomized trial, comparing endoscopic RA harvest versus open technique, showed no negative affect in the length of harvested RA, harvest time, conduit quality, occurrence of hand and forearm complications, and wound healing ( 40 ). The GEA, on the other hand, can be harvested as skeletonized or pedicled with skeletonization reported to be remarkably superior by preventing vasoconstriction, with the conduit remaining wider and longer ( 41 ).…”

Section: Conduits For Cabgmentioning

confidence: 99%

Conduits’ Biology Regulates the Outcomes of Coronary Artery Bypass Grafting

Gharibeh

Ferrari

Ouimet

et al. 2021

JACC: Basic to Translational Science

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Section: Conduits For Cabgmentioning

confidence: 99%

Conduits’ Biology Regulates the Outcomes of Coronary Artery Bypass Grafting

Gharibeh

Ferrari

Ouimet

et al. 2021

JACC: Basic to Translational Science

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“…Verapamil, a calcium channel blocker, when used with nitrate during the angiography operation did not significantly alter the outcomes. Verapamil does not increase the antagonist effect against radial spasm, despite its relationship with nitrate and the creation of temporary heart block [18][19] . In the current study, it was discovered that male patients underwent angiography more frequently than female patients.…”

Section: Discussionmentioning

confidence: 89%

Effectiveness of Calcium Channel Blockers and Nitrates in Inhibition of Spasm of Radial Artery during Coronary Angiography

Arfat¹,

Faraz²,

Nazim³

et al. 2023

PJMHS

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Background: The most common issue with transradial cardiac catheterization is radial artery vasospasm. The patient experiences pain and discomfort as a result, the procedure is prolonged, and the interventionist may even be unable to continue. Aim: The aim of the study is to determine the effectiveness of Verapamil, a calcium channel blocker and nitrate, when used together to prevent radial artery spasm during coronary angiographies. Methods: This case control study was held in the Cardiology department of Qazi Hussain Ahmed Medical Complex, Nowshera and Peoples University of Medical and Health Sciences for Women PUMHSW (SBA) Nawabshah for six-months duration from July 2021 to December 2021 including 120 cardiac patients undergoing coronary angiography. The patients were selected by non-probability sampling technique. Patients who were enrolled in the study provided written informed consent. Two groups of patients—control (60) and experimental—were formed (60). Heparin/nitrate was administered to one group and labelled as a control group, while heparin/nitrates/verapamil (a calcium channel blocker) was administered to the other group considered as an experimental group. During the angiography procedure, the radial spasm, discomfort, and catheter resistance were assessed in both groups. A predesigned questionnaire was used to collect all other demographic data and patient’s history. SPSS version 23.0 was used to collect and analyse the data. Results: It was found that 68.3% of cardiac patients were over 50 years old, 41.7% of patients were female, and 58.3% of patients were male. Verapamil, a calcium channel blocker, and nitrate did not significantly affect radial spasm, according to this study with a p value of 0.762. According to the study, there was no obvious difference noted in radial spasm, outcome, discomfort, catheter resistance, or procedure time when cases and controls were compared for various variables. However, the test group have a 100% success rate of the procedure compared to the control group's 95%. Conclusion: Verapamil, a calcium channel blocker when combined with nitrate did not significantly reduce radial spasm during coronary angiography. The theory that calcium channel blockers could prevent radial artery spasm during angiography was nullified. It is best to avoid the financial burden that comes with using calcium channel blockers and nitrate during coronary angiography. Combining nitrate and calcium channel blocker (Verapamil) has no additional advantages. Keywords: Angiography, catheterization, calcium channel blocker, radial spasm, nitrate, and verapamil are some of the related terms.

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“…Third, minimally invasive or endoscopic harvesting for SV or arterial conduits were not evaluated as are not routinely performed in our center. Despite the recent interest and apparent benefits, 44,45 whether using these techniques would have reduced blood consumption in the SV‐CABG remains unknown. In fact, previous studies comparing endoscopic SV harvesting to open SV harvesting have demonstrated no significant difference in the incidence of RBC transfusions 46 or hematoma formation 47 …”

Section: Discussionmentioning

confidence: 99%

Total arterial coronary artery bypass grafting in patients with preoperative anemia

Spadaccio

Nenna

Candura

et al. 2022

Journal of Cardiac Surgery

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Objectives Blood transfusions after coronary artery bypass grafting (CABG) has been associated to adverse outcomes, especially in anemic patients. However, little is known about the influence of the modality of revascularization. Total arterial revascularization (TAR) was shown to reduce postoperative transfusion when compared to saphenous vein‐based (SV)‐CABG (LIMA plus one/more SV grafts). We, therefore, aimed to investigate the impact of TAR‐CABG versus SV‐CABG on blood products use and perioperative outcomes in patients with preoperative anemia, normally at higher risk for postoperative transfusions. Methods From a cohort of 936 patients with mild preoperative anemia undergoing primary elective on‐pump CABG, 166 matched pairs of patients undergoing either TAR‐ or SV‐CABG were obtained. Anemia was defined as hemoglobin level <13 g/dl for men and <12 g/dl for women. The primary endpoint was the evaluation of red packed cells (RPC) use over the entire hospital stay. Results TAR patients showed significantly reduced RPC usage compared with SV (mean difference 0.45 units). TAR patients had a reduced intubation time (mean difference 7.6 h) and were discharged 1.24 days earlier than SV patients. Pneumonia and acute kidney injury were doubled among SV patients. Adjusted regression showed that TAR technique is a predictor of reduced RPC unit use regardless of age and EuroSCORE II (odds ratio: 0.63, p < .01). Conclusion Patients with preoperative anemia might benefit from TAR regardless of age or calculated operative risk. TAR‐CABG was associated to reduced postoperative use of blood products and postoperative length of stay in comparison with SV‐CABG in this subset of patients.

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Prospective randomized trial of endoscopic vs open radial artery harvest for CABG: Clinical outcome, patient satisfaction, and midterm RA graft patency

Cited by 10 publications

References 26 publications

Conduits’ Biology Regulates the Outcomes of Coronary Artery Bypass Grafting

Conduits’ Biology Regulates the Outcomes of Coronary Artery Bypass Grafting

Effectiveness of Calcium Channel Blockers and Nitrates in Inhibition of Spasm of Radial Artery during Coronary Angiography

Total arterial coronary artery bypass grafting in patients with preoperative anemia

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