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Radial artery graft

Orazio Valsecchi, Angelina Vassileva, Alberto Francesco Cereda, Paolo Canova, Keisuke Satogami, Luigi Fiocca, Giulio Guagliumi
BACKGROUND: Distal transradial access in the anatomical snuffbox has advantages over standard access in terms of patient and operator comfort levels and risk of ischemia. Radial artery preservation could be a relevant issue in patients requiring multiple radial artery procedures and coronary bypass with the use of a radial graft. One relevant drawback is the challenging puncture of a small and weak artery, with a steeper learning curve. AIM: The study was aimed at proving feasibility and safety of right and left transradial access in the anatomical snuffbox...
March 15, 2018: Journal of Invasive Cardiology
Paul S Pagel, Lonnie Dye, Brent T Boettcher, Julie K Freed
OBJECTIVE: Blood flow across the mitral valve during early left ventricular (LV) filling produces a 3-dimensional rotational fluid body, known as a vortex ring, that enhances LV filling efficiency. Diastolic dysfunction is common in elderly patients, but the influence of advanced age on vortex formation is unknown. The authors tested the hypothesis that advanced age is associated with a reduction in LV filling efficiency quantified using vortex formation time (VFT) in octogenarians undergoing coronary artery bypass graft (CABG) surgery...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Alec Vishnevsky, Michael P Savage, David L Fischman
Percutaneous coronary intervention (PCI) of mammary artery bypass grafts through a trans-radial (TR) approach can present unique challenges, including coaxial vessel engagement of the guiding catheter, adequate visualization of the target lesion, sufficient backup support for equipment delivery, and the ability to reach very distal lesions. The GuideLiner catheter, a rapid exchange monorail mother-in-daughter system, facilitates successful interventions in such challenging anatomy. We present a case of a patient undergoing PCI of a right internal mammary artery (RIMA) graft via TR access in whom the graft could not be engaged with any guiding catheter...
March 9, 2018: Catheterization and Cardiovascular Interventions
Agata Schneider, Tomasz Krauze, Andrzej Mińczykowski, Miłosz Dziarmaga, Jarosław Piskorski, Adam Szczepanik, Agnieszka Banaszak, Przemysław Guzik, Andrzej Wykrętowicz
INTRODUCTION    The excess pressure-time integral (excessPTI) and the reservoir pressure-time integral (reservoirPTI) are new metrics derived from blood pressure (BP) waveform decomposition. These markers predict cardiovascular (CV) complications and are associated with target organ damage in treated hypertensive patients or subjects with chronic and acute heart failure. OBJECTIVES    Herein we investigated whether reservoirPTI or excessPTI predict future CV events (death, stroke, myocardial infarction) in subjects with acute coronary syndrome (ACS) and diminished ejection fraction (EF)...
March 9, 2018: Polish Archives of Internal Medicine
Mladen I Vidovich
No abstract text is available yet for this article.
March 12, 2018: JACC. Cardiovascular Interventions
Tim Kinnaird, Richard Anderson, Sean Gallagher, James Cockburn, Alex Sirker, Peter Ludman, Mark de Belder, Samuel Copt, James Nolan, Azfar Zaman, Mamas Mamas
OBJECTIVES: Using the British Cardiovascular Intervention Society percutaneous coronary intervention (PCI) database, access site choice and outcomes of patients undergoing PCI with previous coronary artery bypass grafting (CABG) were studied. BACKGROUND: Given the influence of access site on outcomes, use of radial access in PCI-CABG warrants further investigation. METHODS: Data were analyzed from 58,870 PCI-CABG procedures performed between 2005 and 2014...
March 12, 2018: JACC. Cardiovascular Interventions
Mario Gaudino, Francesco Burzotta, Faisal Bakaeen, Olivier Bertrand, Filippo Crea, Antonino Di Franco, Stephen Fremes, Ferdinand Kiemeneij, Yves Louvard, Sunil V Rao, Thomas A Schwann, James Tatoulis, Robert F Tranbaugh, Carlo Trani, Marco Valgimigli, Pascal Vranckx, David P Taggart
This article summarizes the current research on the benefits of using the transradial approach for percutaneous procedures and the radial artery as a conduit for coronary artery bypass surgery. Based on the available evidence, the authors provide recommendations for the use of the radial artery in patients undergoing percutaneous or surgical coronary procedures.
March 13, 2018: Journal of the American College of Cardiology
Patrizia Presbitero, Loredana Iannetta, Paolo Pagnotta, Bernhard Reimers, Marco L Rossi, Dennis Zavalloni Parenti, Giovanni Bianchi, Francesco Bedogni
BACKGROUND: It is well known that bicuspid valve stenosis can be treated with transcatheter aortic valve implantation (TAVI) even if specific issues can cause problems: dilatation of ascending aorta, possible aorthopathy, eccentricity of the valve and calcium distribution in leaflets and in commissures. We classified Bicuspid aortic valve (BAV) in type 0 (2 cusps and no raphe), and type 1 (2 cusps and one or more raphes). The aim of the present study was to report the results of two types of valve (CoreValve from 2009 to 2016 and Lotus valve from 2014 to 2017) in a consecutive series of BAV patients treated in 2 Italian centers...
April 2018: Minerva Cardioangiologica
Do Jung Kim, Seung Hyun Lee, Hyun-Chel Joo, Kyung-Jong Yoo, Young-Nam Youn
OBJECTIVES: The purpose of this study was to evaluate mid-term patency and clinical outcomes according to the proximal anastomosis site after off-pump coronary artery bypass using the radial artery (RA). METHODS: From January 2001 to December 2015, 1124 patients who underwent isolated off-pump coronary artery bypass using the RA were reviewed and divided into 2 groups: the composite Y-graft (n = 1014, Y group) and aortocoronary graft (n = 110, Aorta group)...
February 28, 2018: European Journal of Cardio-thoracic Surgery
George Hahalis, Grigorios Tsigkas, Nikos Kounis, Sotirios Patsilinakos, Nikolaos Kafkas, Antonios Ziakas, Nikolaos Patsourakos, George Almpanis, Ioanna Koniari, Ioanna Xanthopoulou, Nikolaos Koutsogiannis, Stefanos Despotopoulos, Marianna Leopoulou, Vasiliky Tassi, Ioannis Miliordos, Maria Anastasopoulou, Anastasios Roumeliotis, Athina Dapergola, Konstantinos Aznaouridis, Dimitrios Chatzis, Periklis Davlouros
Radial artery (RA) occlusion (RAO) remains the Achilles heel of transradial coronary procedures. Although of silent nature, RAO is relatively frequent, results in graft shortage for future coronary artery bypass surgery, and may occur even after short-lasting, 5F coronary angiography (CAG). The most frequent predictors of RAO are RA size, body size, female gender, and periprocedural anticoagulation intensity. Methods to detect RAO are variable, of which the Barbeau test and ultrasonography have similar diagnostic accuracy...
January 1, 2018: Angiology
Burak Ozdemir, Cory M Kelly, Michael R Levitt, Louis J Kim
Giant, partially-thrombosed basilar artery (BA) aneurysms are extraordinarily difficult to treat. Due to the high risk of rupture exclusion of these aneurysms from the circulation is imperative. In certain instances, direct clipping is unsuitable, and high-flow bypass and proximal parent vessel clip occlusion is required. We report a case of a recurrent partially-thrombosed giant BA apex aneurysm treated with endovascular stent-coiling through a previous radial artery bypass graft. Following the initial bypass and aneurysm trapping six years prior, the patient was neurologically stable until three months prior to admission when he developed new diplopia and left third nerve palsy...
February 23, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Oliver Vincent Cawley, Anna S Walsh, Imran Asghar, Hans U Desmarowitz, George A Antoniou
Dog bites in the upper limbs have particular significance, as despite the small size of the puncture wounds, penetration is deep, causing serious injuries to deeper structures. There is currently very little data relating to upper extremity dog bite arterial injury. We present the case of a 32-year-old man who sustained a dog bite injury to his right arm, leading to direct puncture and spasm of the brachial artery. He was successfully treated with a jump bypass graft to the right brachial artery, with the use of the reversed ipsilateral cephalic vein as a conduit...
February 23, 2018: Annals of Vascular Surgery
Logan W Carr, Sebastian M Brooke, T Shane Johnson, Brett F Michelotti
Background: The lateral arm flap is used for composite defects in need of vascularized soft tissue, skin, and bone. From its original description, the distal humeral metaphysis can be included with the flap, supplied by the periosteal extensions of the posterior branch of the radial collateral artery. We sought to reexplore the anatomy of the lateral arm to determine its utility as a donor site for vascularized bone. Methods: Twelve fresh, silicone-injected cadaver dissections were performed...
January 2018: Plastic and Reconstructive Surgery. Global Open
Thomas A Schwann, Robert H Habib, Amelia Wallace, David M Shahian, Sean O'Brien, Jeffery P Jacobs, John D Puskas, Paul A Kurlansky, Milo C Engoren, Robert F Tranbaugh, Mark R Bonnell
BACKGROUND: More than 90% of coronary artery bypass grafting (CABG) is performed with a single-arterial bypass graft (SABG), based on the left internal thoracic artery (ITA) with supplemental vein grafts. This practice, often justified by safety concerns with multiple-arterial grafting (MABG), defies evidence of improved late survival achieved with bilateral ITA (BITA-MABG) or left ITA plus radial artery (RA-MABG). We hypothesized that MABG and SABG are equally safe. METHODS: We analyzed The Society of Thoracic Surgeons National Database (2004 to 2015) to assess the operative safety of BITA-MABG (n = 73,054) and RA-MABG (n = 97,623) vs SABG (n = 1,334,511)...
February 13, 2018: Annals of Thoracic Surgery
Samuel H Hui, Ryan Folsom, Lois A Killewich, Joel E Michalek, Mark G Davies, Lori L Pounds
BACKGROUND: Duplex ultrasound (DUS) mapping of the veins and arteries of the upper extremity is a well-established practice in arteriovenous fistula creation for long-term hemodialysis access. Previous publications have shown that vein diameters varying from 2 to 3 mm are predictive of success. Regional anesthesia is known to result in vasodilation and thus to increase the diameter of upper extremity veins. This study compares the sizes of veins measured by preoperative DUS mapping with those obtained after regional anesthesia to determine whether intraoperative DUS results in increased vein diameters and thus changes in the operative plan...
February 13, 2018: Journal of Vascular Surgery
Jan-Karl Burkhardt, Ethan Winkler, Halima Tabani, Sirin Gandhi, Arnau Benet, Michael T Lawton
No abstract text is available yet for this article.
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Thomas A Schwann, Abdul Karim M El Hage Sleiman, Maroun B Yammine, Robert F Tranbaugh, Milo Engoren, Mark R Bonnell, Robert H Habib
BACKGROUND: Multi-arterial coronary grafting with two arterial grafts (2-art) leads to improved survival compared to conventional single-arterial (1-art) based on left internal thoracic artery to left anterior descending (LITA-LAD) and saphenous vein grafts. We investigated whether extending arterial grafting to three or more arterial (3-art) grafts further improves survival, and whether such a benefit is modified by diabetes. METHODS: We analyzed fifteen-year CABG mortality data in 11,931 patients [64...
February 2, 2018: Annals of Thoracic Surgery
Jeremy R Leonard, Ahmed A Abouarab, Derrick Y Tam, Leonard N Girardi, Mario F L Gaudino, Stephen E Fremes
BACKGROUND: The radial artery (RA) is a frequently used conduit for coronary artery bypass graft (CABG). We review the results of the use of the RA in CABG patients and discuss the unique technical considerations when using this conduit. METHODS: A literature search was performed in PubMed through December 2017 on the comparative efficacy of the RA to other conduits and technical considerations for the use of the RA in CABG surgery. RESULTS: When compared to the saphenous vein graft, the RA proved to be superior in graft patency in multiple randomized clinical trials...
February 5, 2018: Journal of Cardiac Surgery
Stylianos Dragasis, Nikolaos Kafkas, Charalampos I Liakos
Radial artery use as a bypass conduit is well established during the last decades, in terms of both patency and safety. On the other hand, transradial catheterization causes a series of structural and functional changes to the vessel itself. Impairment of nitric oxide-dependent vasodilation and notable decrease on radial artery diameter due to intima thickening and hyperplasia, especially during the first 3 months after its cannulation, constitute some of the most important alterations on the radial artery wall and its function after a transradial coronary catheterization procedure...
January 25, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Thomas A Schwann, Mario Gaudino, Mustafa Baldawi, Robert Tranbaugh, Alexandra N Schwann, Robert H Habib
The current literature on radial artery grafting is reviewed focusing on the optimal deployment of radial artery grafts in coronary artery bypass surgery with specific attention to the selection of patients and target vessels for radial artery grafting.
January 25, 2018: Journal of Cardiac Surgery
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