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1.
Scand Cardiovasc J ; 56(1): 127-131, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-35652508

RESUMEN

Objectives. To determine risk factors for radial artery and saphenous vein graft occlusion during long-term follow-up after coronary artery bypass grafting (CABG). Methods: From a cohort of 119 patients who had received a radial artery graft, 76 - of whom 55 also had at least one saphenous vein graft - underwent a preplanned direct angiography and anthropometric, biochemical, and endothelial function assessment 7.6-12.1 (mean 8.9) years after CABG. Comorbidity, medication, and smoking habits were also recorded. The association between these parameters and conduit longevity was analyzed in univariable and multivariable logistic regression models. Results: Radial artery graft occlusions were associated with higher plasma levels of high-sensitive C-reactive protein and patency was best among patients with pharmacologically treated hypertension. The sole independent risk factor identified for saphenous vein graft occlusion was tobacco smoking 8-12 years postoperatively. Conclusion: Our data support the contention that the pathogenesis of radial artery graft failure is distinct from vein graft disease and is related to hypertension status and systemic inflammation. These risk factors are potential targets for preventive measures. Accordingly, the study supports the eventual design of personalized secondary prevention regimens.Clinical registration number: ISRCTN23118170.


Asunto(s)
Hipertensión , Arteria Radial , Angiografía Coronaria , Humanos , Factores de Riesgo , Vena Safena/trasplante , Resultado del Tratamiento , Grado de Desobstrucción Vascular
2.
Scand Cardiovasc J ; 54(5): 330-335, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32603197

RESUMEN

Objectives: The benefits of coronary artery bypass surgery depend on lasting graft patency. To aid rational graft selection, the relative long-term merits of radial artery and saphenous vein grafts need to be determined by a gold standard method and with minimal clinically driven selection bias. Methods: The patency rates of various conduits were determined by direct angiography in 76 patients from a cohort of 119 undergoing coronary artery bypass grafting 7.6-12.1 (mean 8.9) years before. Results: 14 out of 76 radial artery and 10 out of 61 saphenous vein grafts were occluded (rates 0.18 and 0.16, respectively). Conclusion: The high long-term patency rate of saphenous vein grafts does not support a preferential use of the radial artery as a coronary artery bypass conduit. Clinical registration number: ISRCTN23118170.


Asunto(s)
Angiografía , Puente de Arteria Coronaria , Arteria Radial/trasplante , Vena Safena/trasplante , Grado de Desobstrucción Vascular , Puente de Arteria Coronaria/efectos adversos , Oclusión de Injerto Vascular/diagnóstico por imagen , Oclusión de Injerto Vascular/etiología , Oclusión de Injerto Vascular/fisiopatología , Humanos , Noruega , Valor Predictivo de las Pruebas , Arteria Radial/diagnóstico por imagen , Arteria Radial/fisiopatología , Vena Safena/diagnóstico por imagen , Vena Safena/fisiopatología , Factores de Tiempo , Resultado del Tratamiento
3.
Scand Cardiovasc J ; 44(4): 230-6, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20331352

RESUMEN

UNLABELLED: The radial artery is resistant to atherosclerotic degeneration and therefore appears more attractive for coronary artery bypass grafting than the saphenous vein. However, the patency of radial artery grafts varies widely among studies. Therefore, before deciding whether to adopt this as the conduit of choice second to internal mammary artery grafts, we have prospectively monitored our first cohort of patients with radial-to-coronary bypasses. DESIGN: Angiographic and clinical outcome parameters were registered for the 119 patients receiving radial artery grafts at our institution during April 4, 2001 to October 7, 2003. RESULTS: Reangiography of 102 patients (86%) showed that after two to three years, 79% of the radial artery and 87% of the saphenous vein grafts remained patent. Radial artery harvesting was well tolerated. Patency of radial artery grafts was correlated to diabetes mellitus (detrimental), gender (women had higher occlusion rates), and use of angiotensin inhibiting medication (beneficial). CONCLUSIONS: The pre-study assumption that radial artery grafts would out-perform those of saphenous vein at mid-term is not borne out. The propensity of radial artery graft failure in diabetics and the higher patency associated with angiotensin inhibition might both relate to endothelial modulation of the muscular tone of the graft.


Asunto(s)
Bloqueadores del Receptor Tipo 1 de Angiotensina II/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Puente de Arteria Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/cirugía , Complicaciones de la Diabetes/etiología , Oclusión de Injerto Vascular/etiología , Arteria Radial/trasplante , Vena Safena/trasplante , Grado de Desobstrucción Vascular , Adulto , Anciano , Distribución de Chi-Cuadrado , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/fisiopatología , Complicaciones de la Diabetes/diagnóstico por imagen , Complicaciones de la Diabetes/fisiopatología , Femenino , Oclusión de Injerto Vascular/diagnóstico por imagen , Oclusión de Injerto Vascular/fisiopatología , Oclusión de Injerto Vascular/prevención & control , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Noruega , Oportunidad Relativa , Estudios Prospectivos , Arteria Radial/diagnóstico por imagen , Arteria Radial/efectos de los fármacos , Arteria Radial/fisiopatología , Medición de Riesgo , Factores de Riesgo , Vena Safena/diagnóstico por imagen , Vena Safena/efectos de los fármacos , Vena Safena/fisiopatología , Factores Sexuales , Factores de Tiempo , Resultado del Tratamiento , Grado de Desobstrucción Vascular/efectos de los fármacos
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