Should Radial Arteries Be Used Routinely for Coronary Artery Bypass Grafting?

Verma, Subodh; Szmitko, Paul E.; Weisel, Richard D.; Bonneau, D.; Latter, David A.; Errett, Lee; Leclerc, Yves; Fremes, Stephen E.

doi:10.1161/01.cir.0000136998.39371.ff

Cited by 72 publications

(49 citation statements)

References 58 publications

(61 reference statements)

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“…5 This is unlikely to be due to inherent biological differences between the radial arteries and is more likely to reflect technical issues. We therefore outlined in the Methods section details of the harvesting and implantation techniques of the radial artery.…”

Section: Discussionmentioning

confidence: 99%

“…Observational studies have reported satisfactory early and midterm postoperative radial artery patency rates on the order of 92% at 1 year and 80% at 5 years. 5 A recent prospective, randomized, multicenter trial (the Radial Artery Patency Study [RAPS]) confirmed these observational data, reporting significantly better perfect patency rates of radial artery compared with saphenous vein grafts 1 year postoperatively. However, the radial artery grafts had a significantly higher incidence of compromised flow states.…”

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confidence: 91%

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Radial Artery Versus Saphenous Vein Patency Randomized Trial

et al. 2008

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Background-Graft patency is a fundamental predictor of long-term survival after coronary artery bypass surgery. Left and right internal thoracic artery (arterial) graft patency has been shown to be superior to that of saphenous vein grafts. More recently, the radial artery has been used as an aortocoronary graft, but little is known about the midterm and long-term patency of this conduit. We performed a single-center prospective randomized trial comparing the angiographic patency of radial artery and saphenous vein aortocoronary bypass grafts at 5 years after surgery. Methods and Results-We enrolled 142 patients randomized at a single center to have either the radial artery or saphenous vein grafted to a stenosed branch of the native left circumflex coronary artery. The primary end point was angiographic graft patency 5 years postoperatively. At 5 years, 134 patients were alive and eligible for reangiography (5-year survival, 94.4%). Angiography was performed in 103 patients (77%); 98.3% of radial artery grafts and 86.4% of saphenous vein grafts were patent (Pϭ0.04). Graft narrowing occurred in 10% of patent radial artery grafts and 23% of patent saphenous vein grafts (Pϭ0.01). Conclusions-Radial artery aortocoronary bypass grafts to a stenosed branch of the circumflex coronary artery have an excellent patency rate at 5 years. This was significantly better than the patency rate for saphenous vein grafts and comparable to reported patency rates for internal thoracic artery grafts. (Circulation. 2008;117:2859-2864.)

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Section: Discussionmentioning

confidence: 99%

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confidence: 91%

Radial Artery Versus Saphenous Vein Patency Randomized Trial

et al. 2008

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“…In this study, we demonstrated the ANRIL gene NR_003529 transcript expression in saphenous vein tissues for the first time. We also showed that the CDKN2A gene expression is higher readily accessible, have an adequate length for accessing different vessels in the heart and exhibit the correct diameter for coronary and aortic anastomosis 34) . Cell proliferation is required for the arterial-vein graft to adjust to new hemodynamic conditions.…”

Section: Resultsmentioning

confidence: 68%

The Severity of Internal Carotid Artery Stenosis is Associated with the Cyclin-Dependent Kinase Inhibitor 2A Gene Expression

Bayoğlu

Arslan

Göde

et al. 2014

JAT

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Aim: The INK4b-ARF-INK4a locus in the chromosome 9p21 region is known to play an important role in the development of atherosclerosis. The INK4/ARF transcript p16INK4a inhibits the activity of the cyclin-dependent kinases CDK4/CDK6 and arrests cell-cycle progression. CDK inhibitors also regulate G1/S phase progression in vascular smooth muscle cells (VSMCs) and may modulate the early stages of atherosclerosis. Therefore, we aimed to study the expression of the INK4/ARF locus genes CDKN2A and CDKN2BAS in order to examine the p16 INK4a protein expression and the level of cell proliferation in carotid plaques and saphenous tissue samples. Methods: A total of 50 patients (33 symptomatic subjects and 17 asymptomatic subjects) with carotid atherosclerosis (CA) were studied. The CDKN2A and CDKN2BAS gene expression levels were determined using quantitative real-time polymerase chain reaction (qRT-PCR). All tissue sections were also analyzed for the p16INK4a and proliferating cell nuclear antigen (PCNA) protein expression using immunohistochemistry (IHC). Results: The CDKN2A gene expression was significantly higher in the carotid plaques than in the saphenous tissues (p= 0.009), whereas no such differences were observed in the CDKN2BAS transcripts (p = 0.157). The carotid plaque CDKN2A mRNA levels were higher in the symptomatic patients than in the asymptomatic patients (p = 0.050); this finding was also associated with the severity of internal carotid artery (ICA) stenosis (p=0.034). The p16INK4a immune (＋) cell counts in the carotid plaques were higher in the symptomatic patients than in the asymptomatic patients (p = 0.056), as was the cell proliferation index (p=0.001). Conclusions: An increased CDKN2A gene expression in carotid plaques may increase the severity of ICA stenosis, thus raising the risk of atherosclerosis and contributing to the development of symptoms. In addition, the p16INK4a expression is associated with carotid atherosclerosis in various patient subgroups.J Atheroscler Thromb, 2014; 21:659-671.

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“…Basic study has delineated that the mechanism of severe spasm in the RA is more difficult to reverse compared with the LITA. 42 The functioning of the RA in releasing endothelium-derived relaxing factors such as nitric oxide is the same as for other arterial grafts, as is its constriction function to vasoconstrictive factors. However, the RA has multiple tight muscle layers in the media, which has a higher density of muscle cells than other arterial grafts.…”

Section: Disadvantages Of Ra Usementioning

confidence: 99%

Radial Artery as a Graft for Coronary Artery Bypass Grafting

Kobayashi

2009

Circ J

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Should Radial Arteries Be Used Routinely for Coronary Artery Bypass Grafting?

Cited by 72 publications

References 58 publications

Radial Artery Versus Saphenous Vein Patency Randomized Trial

Radial Artery Versus Saphenous Vein Patency Randomized Trial

The Severity of Internal Carotid Artery Stenosis is Associated with the Cyclin-Dependent Kinase Inhibitor 2A Gene Expression

Radial Artery as a Graft for Coronary Artery Bypass Grafting

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