Radial Artery as Conduit is Safe and Effective in Coronary Bypass Surgery in the Elderly  Single-Central Results From 326 Patients

Chen, Xujun; Chen, Xin; Xie, Donghua; Meng, Fanrong; Shi, Kai-Hu; Xu, Ming

doi:10.1253/circj.cj-08-1000

Cited by 14 publications

(18 citation statements)

References 27 publications

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“…The results are consistent with our previous findings. 4 In conclusion, we have confirmed that, in CABG patients with DM, RA conduits exhibit pre-existing disease, with intimal hyperplasia, endothelial cell injury and endothelial dysfunction that might be responsible for graft occlusion and spasm. Greater care should be taken when selecting RA as an arterial graft in DM patients.…”

Section: Discussionsupporting

confidence: 71%

Comparative study on the histomorphology and molecular biology of radial artery conduits in patients with diabetes mellitus who underwent coronary bypass surgery

Zou

Chen

et al. 2012

Diabetes and Vascular Disease Research

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We studied the impact of diabetes mellitus (DM) on the radial artery (RA) in 30 patients with DM and 30 non-diabetic patients undergoing coronary artery bypass grafting with autologous RA. RAs were recorded as normal if there was no cellular or stromal tissue between the endothelium and the internal elastic lamina. The RA was normal in 26.7% of diabetic and 76.7% of non-diabetic patients (p = 0.000298). Intimal thickness index and intima:media ratio were higher in the former than in the latter (p < 0.05; p < 0.05), with no significant difference in luminal narrowing (p > 0.05). Electron microscopy scores were lower in the non-diabetic group (p < 0.001); endothelial nitric oxide synthase (eNOS) protein expression and optical density were higher (p < 0.001). Von Willebrand factor and endothelin-1 messenger RNA (mRNA) levels were higher in the DM patients (p < 0.001). The quality of the RA in patients with DM was thus inferior to that in non-diabetic patients. Care should be taken when selecting RA as a conduit in patients with DM.

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Section: Discussionsupporting

confidence: 71%

Comparative study on the histomorphology and molecular biology of radial artery conduits in patients with diabetes mellitus who underwent coronary bypass surgery

Zou

Chen

et al. 2012

Diabetes and Vascular Disease Research

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“…The RA can also be used as a graft in coronary artery bypass grafting and as a new access point for radiofrequency catheter ablation of left-sided atrioventricular accessory pathways, but the procedure failure rate will be higher if the RA has a small diameter and anatomical abnormalities, so examining the anatomy of the RA with US before any of these procedures will be helpful for a successful outcome, especially those patients who have undergone a prior transradial coronary procedure. [25][26][27] Study Limitation Firstly, angiography was not performed before the transradial coronary procedure, so we could not compare the accuracy of US and angiography in detecting anatomical abnormalities of the RA. Second, we did not follow up patients to detect RRA occlusion, so we did not have any information about the relationship between mid-and long-term occlusion and the diameter of the RRA.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Study of Forearm Arteries With Ultrasound for Percutaneous Coronary Procedures

Yan

Zhou

Zhao

et al. 2010

Circ J

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Background:In recent years, the radial artery (RA) has become an alternative vascular access site for percutaneous coronary procedures, and the ulnar artery (UA) is another possibility. The objective of this study was to investigate the anatomy of the forearm arteries with ultrasound (US) and to evaluate the effect of the anatomy of the right RA (RRA) on the outcomes of transradial coronary procedures. Methods and Results:The 638 patients undergoing transradial coronary procedures were examined with US for measurement of the diameters of the forearm arteries and determination of their anatomical abnormalities before the procedures. The next day the incidence of RA occlusion was recorded. The diameters of the radial and ulnar arteries were similar (P>0.05). The procedure time was longer in patients with anatomical abnormalities (P<0.05) and whose RRA had a diameter <2 mm (P<0.05). The incidence of procedure failure, and of RA occlusion one day after the procedure was also higher in patients with an anatomical abnormality of the RRA (P<0.01 and P<0.05, respectively) and whose RRA diameter was <2 mm (P<0.05 and P<0.05, respectively). Conclusions:The diameters of the forearm arteries of Chinese people are similar. The small diameter and anatomical abnormalities of the RRA could result in longer procedure time, more incidence of procedure failure and RA occlusion. (Circ J 2010; 74: 686 - 692)

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“…Chen et al reported that the patency rate of the radial artery was good, with 95.8% after a mean follow-up time of 74 months. 29 However, arm wounds are a big disadvantage for female patients. 30 Furthermore, long-term results of graft patency and cardiac-event-free survival compared with SVG are still controversial.…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Clinical and Angiographic Outcomes After Coronary Artery Bypass Surgery

Fukui

Takanashi

2010

Circ J

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Background:The impact of gender on outcome after coronary artery bypass grafting (CABG) is controversial. The aim of this study was to compare the differences of clinical and angiographic outcomes between female and male patients after CABG. Methods and Results:The records of 954 patients who underwent isolated CABG between 2004 and 2009 were reviewed. There were 188 female and 766 male patients. Female patients were smaller (P<0.0001) and had a more unstable status (P=0.0024) preoperatively compared with the male patients. Left internal thoracic artery (ITA) use was identical in both genders. However, the right ITA (P=0.006) and radial artery (P<0.0001) use were less frequent in females compared with that in males. Consequently, the use of saphenous vein grafts (SVGs) was more frequent in females than in males (P<0.0001). Mortality was similar between the genders (1.0% vs 1.1%). Although the rate of major complications was not significantly different between the genders (12.2% vs 9.5%), the cerebrovascular event rate was higher in females compared with that in males (4.3% vs 1.6%; P= 0.0432). Patency rates of arterial grafts were not significantly different between the genders; however, those of SVGs were lower in females than those in males (88.6% vs 96.1%; P=0.0003). Conclusions:The clinical outcomes of females after CABG were comparable with those of males. (Circ J 2010; 74: 2103 - 2108

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Radial Artery as Conduit is Safe and Effective in Coronary Bypass Surgery in the Elderly Single-Central Results From 326 Patients

Cited by 14 publications

References 27 publications

Comparative study on the histomorphology and molecular biology of radial artery conduits in patients with diabetes mellitus who underwent coronary bypass surgery

Comparative study on the histomorphology and molecular biology of radial artery conduits in patients with diabetes mellitus who underwent coronary bypass surgery

Anatomical Study of Forearm Arteries With Ultrasound for Percutaneous Coronary Procedures

Gender Differences in Clinical and Angiographic Outcomes After Coronary Artery Bypass Surgery

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