Randomized comparison of vasodilator effects of iloprost versus diltiazem on flow and pathologic changes in radial arteries: mid-term angiographic control study of the …
H Ustunsoy, H Kazaz, MA Celkan… - The Heart Surgery …, 2009 - journal.hsforum.com
The Heart Surgery Forum, 2009•journal.hsforum.com
Background: The increasing prevalence of routine radial artery (RA) use in coronary artery
bypass grafting (CABG) has rendered the pharmacologic prevention of spasm of this artery a
critical consideration in the early postoperative period and in the long-term outcome. In this
study, we compared the effects of iloprost and diltiazem on vasospasm. Methods: Seventy
patients who underwent CABG with the RA were randomized into 2 groups, and the
vasodilator effects of iloprost and diltiazem were studied prospectively. RA flow was …
bypass grafting (CABG) has rendered the pharmacologic prevention of spasm of this artery a
critical consideration in the early postoperative period and in the long-term outcome. In this
study, we compared the effects of iloprost and diltiazem on vasospasm. Methods: Seventy
patients who underwent CABG with the RA were randomized into 2 groups, and the
vasodilator effects of iloprost and diltiazem were studied prospectively. RA flow was …
Abstract
Background: The increasing prevalence of routine radial artery (RA) use in coronary artery bypass grafting (CABG) has rendered the pharmacologic prevention of spasm of this artery a critical consideration in the early postoperative period and in the long-term outcome. In this study, we compared the effects of iloprost and diltiazem on vasospasm.
Methods: Seventy patients who underwent CABG with the RA were randomized into 2 groups, and the vasodilator effects of iloprost and diltiazem were studied prospectively. RA flow was measured with Doppler ultrasonography. Following harvesting, a 5-mm piece was removed from the RA distally for pathologic examination. In group B, diltiazem was infused before removing the RA, whereas in group A, iloprost infusion was initiated 5 days before surgery. At the end of a 2-year follow-up, each patient underwent coronary angiography.
Results: Doppler flow measurements made during harvesting revealed a statistically significant reduction in flow, and a pathologic examination of the RAs revealed significant luminal narrowing in group B. A 2-year angiographic follow-up revealed all of the RA grafts in group A to be patent.
Conclusions: Our evaluation of the results revealed the superior efficacy of iloprost over diltiazem in preventing RA spasm in the early period, and the 2-year angiographic findings showed that the use of iloprost produced superior mid-term patency.
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