Skeletonized Radial Artery Graft Prepared with Phosphodiesterase-III Inhibitors Indicates Favorable Results Compared with Pedicled Radial Artery Graft in Angiographic Studies

Abstract

<jats:sec><jats:title>Objectives</jats:title><jats:p> The technique used to harvest the radial artery was modified, with improved results. Skeletonized radial artery conduits prepared with phosphodiesterase-III inhibitor were compared with pedicled conduits by angiography. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Isolated coronary artery bypass graft surgery that used the radial artery for conduits was performed on 83 consecutive occasions from March 2003 to February 2004. The mean age of the patients was 68 ± 7 years; 65% were male. The radial arteries were harvested randomly for skeletonized (group SPD and group SPa) or pedicled (group PPD). A phosphodiesterase-III inhibitor, olprinone hydrochloride, was used as an antispastic agent during harvesting of the radial artery for both in groups SPD and PPD. Papaverine was used in group SPa. Postoperative angiograms were performed within 1 month. Diameters of the radial artery were scaled at proximal, mid, and distal sections and averaged. Optical stenosis was measured as a percent stenosis value. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> There were no significant differences among groups SPD, SPa, and PPD in morbidity or mortality rates. Graft patency rates were 97.4% in group SPD, 98.6% in group SPa, and 95.4% in group PPD (P = 0.67). Diameters of the radial artery conduits were significantly wider in group SPD compared with group PPD (P &lt; 0.001). Spasm and stenosis were less frequent in group PPD (P &lt; 0.05). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Skeletonized radial artery grafting prepared with a phosphodiesterase-III inhibitor indicated favorable results in angiographic studies. </jats:p></jats:sec>

Change of luminal diameter of skeletonized and non-skeletonized radial artery graft at early and late postoperative period

“…Our first finding is consistent with several past reports. Yamaguchi et al [ 12 ] reported that on angiography at an early postoperative stage, the mean diameter of the RA was wider and spasm or stenosis was seen less often in skeletonized grafts. Although the underlining mechanism for larger diameter and less vasoreactivity of skeletonized RA remains unknown, there are several possible explanations.…”

Potent Vasodilatory Effect of Fasudil on Radial Artery Graft in Coronary Artery Bypass Operations

“…Na et al [25] observed increase in GFF both in RA and internal thoracic artery, with an increase from 91 to 110 ml/min in RA. The anti-spasm effect was also observed in segment specimens [26,27], but superiority to VG solution has not been reported. Papaverine is one of the most commonly used vasodilators for arterial graft.…”