Graft Patency and Clinical Outcomes in Patients With Radial Artery Grafts Previously Instrumented for Cardiac Catheterization.

التفاصيل البيبلوغرافية
العنوان:	Graft Patency and Clinical Outcomes in Patients With Radial Artery Grafts Previously Instrumented for Cardiac Catheterization.
المؤلفون:	Hamilton GW; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Theuerle J; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Chye D; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia., Bhaskar J; Brian F Buxton Cardiac Surgical Unit (J.B., S.S., J.R.), Austin Health, Melbourne, VIC, Australia., Seevanayagam S; Brian F Buxton Cardiac Surgical Unit (J.B., S.S., J.R.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Johns H; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Churilov L; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Yeoh J; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Yudi MB; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Brown L; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia., Raman J; Brian F Buxton Cardiac Surgical Unit (J.B., S.S., J.R.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Clark DJ; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Hare DL; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.)., Farouque O; Department of Cardiology (G.W.H., J.T., D.C., J.Y., M.B.Y., L.B., D.J.C., D.L.H., O.F.), Austin Health, Melbourne, VIC, Australia.; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia (G.W.H., J.T., S.S., H.J., L.C., J.Y., M.B.Y., J.R., D.J.C., D.L.H., O.F.).
المصدر:	Circulation. Cardiovascular interventions [Circ Cardiovasc Interv] 2024 Jul; Vol. 17 (7), pp. e013739. Date of Electronic Publication: 2024 Jul 08.
نوع المنشور:	Journal Article; Comparative Study
اللغة:	English
بيانات الدورية:	Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101499602 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-7632 (Electronic) Linking ISSN: 19417640 NLM ISO Abbreviation: Circ Cardiovasc Interv Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins
مواضيع طبية MeSH:	Radial Artery/diagnostic imaging , Radial Artery/transplantation , Radial Artery/physiopathology , Vascular Patency , Coronary Artery Bypass/adverse effects , Cardiac Catheterization/adverse effects , Cardiac Catheterization/instrumentation , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/physiopathology , Graft Occlusion, Vascular/diagnostic imaging , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/physiopathology , Coronary Artery Disease/therapy , Coronary Artery Disease/surgery , Coronary Angiography*, Humans ; Male ; Female ; Aged ; Middle Aged ; Treatment Outcome ; Time Factors ; Risk Factors ; Retrospective Studies ; Catheterization, Peripheral/adverse effects ; Punctures ; Risk Assessment
مستخلص:	Background: While transradial access is favored for cardiac catheterization, the radial artery (RA) is increasingly preferred for coronary artery bypass grafting. Whether the RA is suitable for use as a graft following instrumentation for transradial access remains uncertain. Methods: Consecutive patients from 2015 to 2019 who underwent coronary artery bypass grafting using both the left and right RAs as grafts were included. Instrumented RAs underwent careful preoperative assessment for suitability. The clinical analysis was stratified by whether patients received an instrumented RA graft (instrumented versus noninstrumented groups). Eligible patients with both instrumented and noninstrumented RAs underwent computed tomography coronary angiography to evaluate graft patency. The primary outcome was a within-patient paired analysis of graft patency comparing instrumented to noninstrumented RA grafts. Results: Of the 1123 patients who underwent coronary artery bypass grafting, 294 had both the left and right RAs used as grafts and were included. There were 126 and 168 patients in the instrumented and noninstrumented groups, respectively. Baseline characteristics and perioperative outcomes were comparable. The rate of major adverse cardiac events at 2 years following coronary artery bypass grafting was 2.4% in the instrumented group and 5.4% in the noninstrumented group (hazard ratio, 0.44 [95% CI, 0.12-1.61]; P =0.19). There were 50 patients included in the graft patency analysis. At a median follow-up of 4.3 (interquartile range, 3.7-4.5) years, 40/50 (80%) instrumented and 41/50 (82%) noninstrumented grafts were patent (odds ratio, 0.86 [95% CI, 0.29-2.52]; P >0.99). No significant differences were observed in the luminal diameter or cross-sectional area of the instrumented and noninstrumented RA grafts. Conclusions: There was no evidence found in this study that RA graft patency was affected by prior transradial access, and the use of an instrumented RA was not associated with worse outcomes in the exploratory clinical analysis. Although conduits must be carefully selected, prior transradial access should not be considered an absolute contraindication to the use of the RA as a bypass graft. Registration: URL: https://www.anzctr.org.au/; Unique identifier: ACTRN12621000257864. Competing Interests: None.
التعليقات:	Comment in: Circ Cardiovasc Interv. 2024 Jul;17(7):e014194. doi: 10.1161/CIRCINTERVENTIONS.124.014194. (PMID: 38973452)
فهرسة مساهمة:	Keywords: coronary angiography; coronary artery bypass; coronary artery disease; percutaneous coronary intervention; radial artery
سلسلة جزيئية:	ClinicalTrials.gov ACTRN12621000257864
تواريخ الأحداث:	Date Created: 20240708 Date Completed: 20240716 Latest Revision: 20240716
رمز التحديث:	20240717
DOI:	10.1161/CIRCINTERVENTIONS.123.013739
PMID:	38973456
قاعدة البيانات:	MEDLINE

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الوصف
تدمد:	1941-7632
DOI:	10.1161/CIRCINTERVENTIONS.123.013739