Randomized Comparison of Vasodilator Effects of Iloprost versus Diltiazem on Flow and Pathologic Changes in Radial Arteries: Mid-term Angiographic Control Study of the Comparison of Vasodilators on Radial Artery Vasospasm

Authors

  • Hasim Ustunsoy
  • Hakki Kazaz
  • M. Adnan Celkan
  • Hale Deniz
  • Vedat Davutoglu
  • Kemal Bakir
  • Nihat Cine
  • Oktay Burma

DOI:

https://doi.org/10.1532/HSF98.20091020

Abstract

Background: The increasing prevalence of routine radial artery (RA) use in coronary artery bypass grafting (CABG) has rendered the pharmacologic prevention of spasm of this artery a critical consideration in the early postoperative period and in the long-term outcome. In this study, we compared the effects of iloprost and diltiazem on vasospasm.

Methods: Seventy patients who underwent CABG with the RA were randomized into 2 groups, and the vasodilator effects of iloprost and diltiazem were studied prospectively. RA flow was measured with Doppler ultrasonography. Following harvesting, a 5-mm piece was removed from the RA distally for pathologic examination. In group B, diltiazem was infused before removing the RA, whereas in group A, iloprost infusion was initiated 5 days before surgery. At the end of a 2-year follow-up, each patient underwent coronary angiography.

Results: Doppler flow measurements made during harvesting revealed a statistically significant reduction in flow, and a pathologic examination of the RAs revealed significant luminal narrowing in group B. A 2-year angiographic follow-up revealed all of the RA grafts in group A to be patent.

Conclusions: Our evaluation of the results revealed the superior efficacy of iloprost over diltiazem in preventing RA spasm in the early period, and the 2-year angiographic findings showed that the use of iloprost produced superior mid-term patency.

References

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Published

2009-08-14

How to Cite

Ustunsoy, H., Kazaz, H., Celkan, M. A., Deniz, H., Davutoglu, V., Bakir, K., Cine, N., & Burma, O. (2009). Randomized Comparison of Vasodilator Effects of Iloprost versus Diltiazem on Flow and Pathologic Changes in Radial Arteries: Mid-term Angiographic Control Study of the Comparison of Vasodilators on Radial Artery Vasospasm. The Heart Surgery Forum, 12(4), E202-E207. https://doi.org/10.1532/HSF98.20091020

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