کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2893557 1172416 2009 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Intraoperative detection of intimal lipid in the radial artery predicts degree of postoperative spasm
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Intraoperative detection of intimal lipid in the radial artery predicts degree of postoperative spasm
چکیده انگلیسی

BackgroundThe radial artery's (RA) tendency to spasm when used as a bypass graft may relate to features of the RA itself. We imaged RA conduits before and after CABG in order to characterize intimal abnormalities that might relate to the risk of spasm.MethodsRA conduits from thirty-two CABG patients were imaged intraoperatively using catheter-based optical coherence tomography (OCT) and again on day 5 using 64-channel MDCT angiography. The change in luminal diameter between timepoints was measured in the proximal, mid and distal RA. “Spasm” was defined as focal or diffuse luminal narrowing to a diameter less than the target coronary. Lipid content in the RA was quantified by the degree of light attenuation on the OCT image.ResultsPostoperative spasm was diagnosed in 18 of 32 (56%) RA grafts with the distal RA showing the most severe change versus the mid and proximal portions (−24.1 ± 43.2% vs. −15.3 ± 40.7%, −9.0 ± 42.5% change in diameter respectively, p < 0.01). The degree of attenuation of the OCT signal produced by the RA was strongly correlated with % diameter change (R = 0.64, p = 0.0005) and was significantly more pronounced in grafts with spasm versus no spasm (−1.97 ± 0.61 mm−1 vs. −0.81 ± 0.57 mm−1, p < 0.0001). Histology confirmed lipid deposits in areas of RA with strong attenuation.ConclusionsRA conduits otherwise considered acceptable for bypass grafting were often found by OCT imaging to have a substantial amount of lipid, which in turn strongly relates to the risk of postoperative spasm. Screening conduits based on characteristics of intimal quality may improve results following RA grafting.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Atherosclerosis - Volume 205, Issue 2, August 2009, Pages 466–471
نویسندگان
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