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Radial artery graft

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https://www.readbyqxmd.com/read/28795296/current-trends-in-selection-of-conduits-for-coronary-artery-bypass-grafting
#1
REVIEW
Thierry Carrel, Bernhard Winkler
The procedure of coronary artery bypass grafting continues to be the "gold standard" for patients with multivessel coronary artery disease and left main stenosis due to favourable long-term and consistent outcomes despite the advent of new generations of stents. But the targeted better long-term outcome of surgical revascularization over percutaneous interventions depends on several variables and aspects; one of them is the choice of conduits used to bypass the stenosed arteries. Coronary artery bypass surgery has been studied and debated for decades and the same applies to the selection of grafts...
August 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28774222/transradial-delivery-of-a-renal-snorkel-during-complex-endovascular-aortic-aneurysm-repair
#2
Jordan R Stern, Sharif H Ellozy
Transradial access has been described in a variety of clinical contexts but has been rarely utilized for visceral artery interventions and during complex endovascular aortic aneurysm repair (EVAR) when upper extremity access is required. This is usually accomplished via brachial artery access, and although brachial access is generally safe and effective, radial access may offer some benefits with regard to patient comfort and potential complications. Here we report a case of successful delivery of a renal snorkel via a radial artery approach during EVAR...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28766859/transulnar-cardiac-catheterization-and-percutaneous-coronary-intervention-techniques-transradial-comparisons-anatomical-considerations-and-comprehensive-literature-review
#3
Subrata Kar
Ulnar arterial access for cardiac catheterization and intervention is an alternative approach compared with radial or femoral access. Ulnar access is infrequently performed since the radial artery is readily palpable and is commonly used worldwide to minimize vascular complications from femoral access. Nevertheless, ulnar access provides a suitable access site in patients who are poor candidates for femoral access, have pre-existing radial occlusion, radial artery hypoplasia or hyperplasia from prior radial artery procedures, radial stenosis, radial loops, radial tortuosity, small radial arteries, and/or have future need for radial graft for dialysis or coronary artery bypass graft...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28763350/a-prospective-randomized-study-of-endoscopic-versus-conventional-harvesting-of-the-radial-artery
#4
Bob B Kiaii, Stuart A Swinamer, Stephanie A Fox, Larry Stitt, Mackenzie A Quantz, Richard J Novick
OBJECTIVE: The aims of the study were to determine whether endoscopic harvesting of the radial artery (RA) reduces morbidity due to pain, infection, and disability with improvement in satisfaction and cosmesis compared to the conventional technique and (2) to compare the 6-month angiographic patency of the RA harvested conventionally and endoscopically. METHODS: In a prospective randomized study, 119 patients undergoing coronary artery bypass grafting using the RA were randomized to have RA harvested either conventionally (n = 59) or endoscopically (n = 60)...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28763313/generalizability-of-excel-and-noble-results-to-a-large-registry-population-with-unprotected-left-main-coronary-artery-disease
#5
Pil Hyung Lee, Se Hun Kang, Seungbong Han, Jung-Min Ahn, Jae Seok Bae, Cheol Hyun Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVE: The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. PATIENTS AND METHODS: We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481)...
July 31, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28760582/improved-outcomes-with-proximal-radial-cephalic-arteriovenous-fistulas-compared-with-brachial-cephalic-arteriovenous-fistulas
#6
Dean J Arnaoutakis, Elise P Deroo, Patrick McGlynn, Maxwell D Coll, Michael Belkin, Dirk M Hentschel, C Keith Ozaki
BACKGROUND: Brachial-cephalic arteriovenous fistulas (BCFs) are associated with high-flow volumes, leading to potential risks such as arm swelling, steal syndrome, pseudoaneurysm (due to a pressurized access), and cephalic arch stenosis. We hypothesized that a proximal radial-cephalic fistula (prRCF) configuration mitigates these risks because a lower flow state is created. Furthermore, we also hypothesized that despite these lower flows, patencies (primary, primary assisted, secondary) are sustained...
July 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28745437/vascularized-ulnar-periosteal-pedicled-flap-for-forearm-reconstruction-anatomical-study-and-a-case-report
#7
Barrera-Ochoa Sergi, Velez Roberto, Rodriguez-Baeza Alfonso, De Bergua-Domingo Josep Maria, Knörr Jorge, Soldado Francisco
PURPOSE: Through an anatomical review, the aim of this study is to define the ulnar periosteal branches of the posterior interosseous vessels (PIV). In addition, we report the clinical utility of a vascularized ulnar periosteal pedicled flap (VUPPF), supplied by the investigated PIV, in a complex case of radial nonunion. METHODS: Ten upper limbs latex colored from fresh human cadavers were used. Branches of the PIV were dissected under 2.5× loupe magnification, noting the periosteal, muscular, and cutaneous branches arising distal to the interosseous recurrent artery...
July 26, 2017: Microsurgery
https://www.readbyqxmd.com/read/28734873/a-computational-fluid-structure-interaction-analysis-of-coronary-y-grafts
#8
Bruno Guerciotti, Christian Vergara, Sonia Ippolito, Alfio Quarteroni, Carlo Antona, Roberto Scrofani
Coronary artery disease is one of the leading causes of death worldwide. The stenotic coronary vessels are generally treated with coronary artery bypass grafts (CABGs), which can be either arterial (internal mammary artery, radial artery) or venous (saphenous vein). However, the different mechanical properties of the graft can influence the outcome of the procedure in terms of risk of restenosis and subsequent graft failure. In this paper, we perform a computational fluid-structure interaction (FSI) analysis of patient-specific multiple CABGs (Y-grafts) with the aim of better understanding the influence of the choice of bypass (arterial vs venous) on the risk of graft failure...
July 19, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28713704/the-anterior-interosseus-artery-perforator-flap-anatomical-dissections-and-clinical-study
#9
Nikhil S Panse, Sheetal B Joshi, Parag B Sahasrabudhe, B Bahetee, Pradnya Gurude, Ajay Chandanwale
BACKGROUND: Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Recently, perforator propeller flaps have been used for resurfacing the upper extremity. The anterior interosseus artery perforator flap is an uncommonly used and described flap...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28683990/how-safe-is-it-to-train-residents-to-perform-coronary-surgery-with-multiple-arterial-grafting-nineteen-years-of-training-at-a-single-institution
#10
Umberto Benedetto, Massimo Caputo, Mario Gaudino, Hunaid Vohra, Pierpaolo Chivasso, Alan Bryan, Gianni D Angelini
The learning curve of coronary artery bypass grafting (CABG) with multiple arterial grafting (MAG) is perceived to be associated with increased surgical morbidity and potentially poorer long-term outcomes. We compared short-term outcomes and long-term survival in patients who underwent CABG with MAG performed by attending surgeons or resident trainees at a single institution over a period of 19 years. Using our institutional database, we identified 3039 patients undergoing MAG from 1996-2015. Of those, 958 (32%) were operated on by residents and 2081 (68%) by attending surgeons...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28678142/ultrastructural-and-histomorphologic-properties-of-the-internal-thoracic-artery-implications-for-coronary-revascularization
#11
Diogo A Fonseca, Pedro E Antunes, Maria D Cotrim
Coronary artery disease represents a major health problem worldwide for which coronary artery bypass surgery remains a standard of care. Among the several grafts that are available, the internal thoracic artery (ITA) has long been considered the best as several advantages have been described compared with other vessels (e.g. saphenous vein or radial artery), namely, an absent to minor atherosclerotic development. In fact, several studies showed the presence of preatherosclerotic lesions, such as intimal and/or medial thickening, medial fibrosis, among others, in the presence of certain cardiovascular risk factors as well as established atherosclerotic lesions (i...
September 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28664690/plasma-magnesium-concentration-in-patients-undergoing-coronary-artery-bypass-grafting
#12
Edyta Kotlinska-Hasiec, Marta Makara-Studzinska, Marek Czajkowski, Ziemowit Rzecki, Krzysztof Olszewski, Adam Stadnik, Jacek Pilat, Beata Rybojad, Wojciech Dabrowski
[b]Introduction[/b]. Magnesium (Mg) plays a crucial role in cell physiology and its deficiency may cause many disorders which often require intensive treatment. The aim of this study was to analyse some factors affecting preoperative plasma Mg concentration in patients undergoing coronary artery bypass grafting (CABG). [b]Materials and method[/b]. Adult patients scheduled for elective CABG with cardio-pulmonary bypass (CPB) under general anaesthesia were studied. Plasma Mg concentration was analysed before surgery in accordance with age, domicile, profession, tobacco smoking and preoperative Mg supplementation...
May 11, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28637292/ten-year-real-life-effectiveness-of-coronary-artery-bypass-using-radial-artery-or-great-saphenous-vein-grafts-in-a-single-centre-chinese-hospital
#13
Yunpeng Zhu, Anqing Chen, Zhe Wang, Jun Liu, Junfeng Cai, Mi Zhou, Qiang Zhao
OBJECTIVES: Long-term effectiveness of coronary artery bypass grafting using radial artery (RA) or great saphenous vein (SVG) grafts as a second conduit was compared. METHODS: Patients received simple elective off-pump coronary artery bypass involving both the left internal thoracic artery (LITA) and the left anterior descending artery between January 1999 and December 2005 at Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China. RA graft patients ( n  = 147 LITA + RA and n  = 61 LITA + RA + SVG) were matched with SVG graft patients ( n  = 208 LITA + SVG)...
June 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28619499/results-of-early-high-flow-bypass-and-trapping-for-ruptured-blood-blister-like-aneurysms-of-the-internal-carotid-artery
#14
Yuichiro Kikkawa, Toshiki Ikeda, Ririko Takeda, Hiroyuki Nakajima, Takeshi Ogura, Hidetoshi Ooigawa, Hiroki Kurita
OBJECTIVE: The aim of this study is to clarify the efficacy and safety of early surgery using trapping of the affected internal carotid artery (ICA) and high-flow bypass between second portion of the middle cerebral artery and cervical external carotid artery with radial artery graft for ruptured blood blister-like aneurysms (BBAs) arising from anterior wall of the ICA. METHODS: Medical chart of consecutive 16 patients (M:F=7:9, mean 59 years) with subarachnoid hemorrhage (WFNS grade I:2, II:5, III:2, IV:4, V:3) due to ruptured BBA surgically treated between July 2010 and October 2015 were retrospectively reviewed...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28610970/internal-maxillary-artery-bypass-with-radial-artery-graft-treatment-of-giant-intracranial-aneurysms
#15
Long Wang, Shuaibin Lu, Hai Qian, Xiang'en Shi
BACKGROUND: Giant intracranial aneurysms (GIAs) can be approached via microsurgical and endovascular techniques. Utilization of flow diversion devices (FDDs) has yielded favorable outcomes, and indications for cerebral revascularization have dramatically decreased. OBJECTIVE: To evaluate the safety and validity of using internal maxillary artery (IMA) bypass with an interposed graft to treat GIAs. METHODS: During a 6-year period, high-flow IMA bypass procedures were performed in 32 patients with GIAs at our institute...
June 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28600020/trans-ulnar-recanalization-of-a-chronic-radial-artery-occlusion
#16
Orazio Valsecchi, Matteo Nardin, Angelina Vassileva, Chiara Bernelli
Trans-ulnar access is a viable alternative approach by experienced operators when the radial and femoral arteries cannot be accessed or used to preserve the contralateral radial artery as possible vascular graft for coronary bypass surgery, hemodynamic monitoring, or shunt creation for hemodialysis. We report a challenging case of ipsilateral trans-ulnar recanalization of a chronic radial artery occlusion, which allowed us to perform a complex trans-ulnar PCI.
April 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28594659/repeat-revascularization-after-minimally-invasive-coronary-artery-bypass-grafting-is-it-a-problem
#17
Maria L Rodriguez, Harry R Lapierre, Benjamin F Sohmer, Marc A Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) via a small left thoracotomy is a novel technique for coronary revascularization that is increasingly used around the world. However, multivessel MICS CABG is difficult, and concerns about repeat revascularization (RR) have been raised. This longitudinal study describes the rates of RR among patients who have undergone MICS CABG and identifies targets for improvement. METHODS: A prospective observational study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28592080/-complete-revascularization-for-multi-vessel-coronary-diseases-through-lower-ministernotomy-on-beating-heart-off-pump-surgery
#18
Z B Xiao, Y Zhang, J Z Guo, Y Y Li, Y P Zhang
Objective: To discuss a novel method of complete revascularization for multi-vessel coronary diseases on beating heart off-pump surgery through lower ministernotomy. Methods: Clinical data of 79 patients underwent ministernotomy off-pump coronary artery bypass from January 2015 to May 2016 at Department of Cardiac Surgery, Heart Center, Beijing Friendship Hospital, Capital Medical University were analyzed retrospectively. There were 62 male and 17 female patients, with an average age of (65±9) years. All the patients were multi-vessel coronary diseases and planned to receive coronary artery bypass grafting...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28567356/radial-artery-occlusion-after-transradial-coronary-catheterization
#19
REVIEW
Grigorios Avdikos, Aris Karatasakis, Andreas Tsoumeleas, Efstathios Lazaris, Antonios Ziakas, Michael Koutouzis
The transradial approach (TRA) for coronary angiography and interventions is increasingly utilized around the world. Radial artery occlusion (RAO) is the most common significant complication after transradial catheterization, with incidence varying between 1% and 10%. Although RAO is rarely accompanied by hand ischemia, it is an important complication because it prohibits future transradial access and radial artery utilization as a conduit for coronary artery bypass grafting or arteriovenous fistula formation...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28566338/associations-between-adding-a-radial-artery-graft-to-single-and-bilateral-internal-thoracic-artery-grafts-and-outcomes-insights-from-the-arterial-revascularization-trial
#20
David P Taggart, Douglas G Altman, Marcus D Flather, Stephen Gerry, Alastair M Gray, Belinda Lees, Umberto Benedetto
Background -Whether the use of the radial artery (RA) can improve clinical outcomes in coronary artery bypass graft (CABG) surgery remains unclear. The Arterial Revascularization Trial (ART) was designed to compare survival after bilateral internal thoracic artery (BITA) over single left internal thoracic artery (SITA). In the ART, a large proportion of patients (~20%) also received a RA graft instead of a saphenous vein graft (SVG). We aimed to investigate the associations between using the RA instead of SVG to supplement SITA or BITA grafts and outcomes by performing a post-hoc analysis of the ART...
May 31, 2017: Circulation
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