Radial artery graft stenosis treated by percutaneous intervention

Goube, Pascal; Hammoudi, Nadjib; Pagny, Jean-Yves; Boutekadjirt, Redha; Toledano, Daniel; Achouh, Paul; Acar, Christophe

doi:10.1016/j.ejcts.2009.06.058

Cited by 12 publications

(6 citation statements)

References 23 publications

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“…95 Balloon PCI can be used in the early postoperative period, during which the occurrence of spasm is difficult to prevent. 96 Limited information is available on the percutaneous treatment of radial grafts and long-term outcomes. 95,96 Optimal medical treatment…”

Section: Secondary Pci In Svgsmentioning

confidence: 99%

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Secondary revascularization after CABG surgery

Escaned

2012

Nat Rev Cardiol

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CABG surgery is an effective way to improve symptoms and prognosis in patients with advanced coronary atherosclerotic disease. Despite multiple improvements in surgical technique and patient treatment, graft failure after CABG surgery occurs in a time-dependent fashion, particularly in the second decade after the intervention, in a substantial number of patients because of atherosclerotic progression and saphenous-vein graft (SVG) disease. Until 2010, repeat revascularization by either percutaneous coronary intervention (PCI) or surgical techniques was performed in these high-risk patients in the absence of specific recommendations in clinical practice guidelines, and within a culture of inadequate communication between cardiac surgeons and interventional cardiologists. Indeed, some of the specific technologies developed to reduce procedural risk, such as embolic protection devices for SVG interventions, are largely underused. Additionally, the implementation of secondary prevention, which reduces the need for reintervention in these patients, is still suboptimal. In this Review, graft failure after CABG surgery is examined as a clinical problem from the perspective of holistic patient management. Issues such as the substrate and epidemiology of graft failure, the choice of revascularization modality, the specific problems inherent in repeat CABG surgery and PCI, and the importance of secondary prevention are discussed.

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Section: Secondary Pci In Svgsmentioning

confidence: 99%

“…96 Limited information is available on the percutaneous treatment of radial grafts and long-term outcomes. 95,96 Optimal medical treatment…”

Section: Secondary Pci In Svgsmentioning

confidence: 99%

Secondary revascularization after CABG surgery

Escaned

2012

Nat Rev Cardiol

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“…On rare occasions, direct angioplasty of a radial conduit was performed on a localized stenosis of the graft. The significance of radial graft stenosis has been discussed in a separate article [12]. Almost half of the patients in this series underwent at least one angiographic control.…”

Section: Discussionmentioning

confidence: 98%

Reappraisal of a 20-year experience with the radial artery as a conduit for coronary bypass grafting

Achouh

Isselmou

Boutekadjirt

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…The RA graft spasm was demonstrated by angiography and was successfully resolved by intravenous nitroglycerin administration. However, focal RA graft stenosis may be difficult to differentiate from spasm and can be treated by percutaneous intervention [53].…”

Section: Spasm Of Other Arterial Graftsmentioning

confidence: 99%

Spasm in Arterial Grafts in Coronary Artery Bypass Grafting Surgery

Taggart

2016

The Annals of Thoracic Surgery

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Spasm of arterial grafts in coronary artery bypass grafting surgery is still a clinical problem, and refractory spasm can occasionally be lethal. Perioperative spasm in bypass grafts and coronary arteries has been reported in 0.43% of all coronary artery bypass grafting surgery, but this may be an underestimate. Spasm can develop not only in the internal mammary artery but more frequently in the right gastroepiploic and radial artery. The mechanism of spasm can involve many pathways, particularly those involving regulation of the intracellular calcium concentration. Endothelial dysfunction also plays a role in spasm. Depending on the clinical scenario, the possibility of spasm during and after coronary artery bypass grafting should be confirmed by angiography. If present, immediate intraluminal injection of vasodilators is often effective, although other procedures such as an intraaortic balloon pump or extracorporeal membrane oxygenation may also become necessary to salvage the patient. Prevention of spasm involves many considerations, and the principles are discussed in this review article.

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Radial artery graft stenosis treated by percutaneous intervention

Cited by 12 publications

References 23 publications

Secondary revascularization after CABG surgery

Secondary revascularization after CABG surgery

Reappraisal of a 20-year experience with the radial artery as a conduit for coronary bypass grafting

Spasm in Arterial Grafts in Coronary Artery Bypass Grafting Surgery

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