Key result
Topical verapamil-nitroglycerin significantly reduced the incidence of radial artery graft occlusion compared to papaverine (3 vs 10 occlusions) following coronary artery bypass.
Why the study?
Does topical verapamil-nitroglycerin prevent graft spasm and occlusion compared to papaverine in patients undergoing coronary artery bypass using a radial artery?
Cohort (n=215)
Does topical verapamil-nitroglycerin prevent graft spasm and occlusion compared to papaverine in patients undergoing coronary artery bypass using a radial artery?
Topical verapamil-nitroglycerin appears more effective than papaverine in preventing radial artery graft occlusion after coronary artery bypass surgery.
May support verapamil-nitroglycerin over papaverine for radial grafts; hypothesis-generating and requires randomized confirmation before practice change.
The best way to prevent spasm of the radial artery is still under investigation. We retrospectively compared the effectiveness of topical verapamil-nitroglycerin with papaverine in preventing graft spasm in 215 patients who underwent isolated conventional coronary artery bypass using a radial artery. Postoperative angiographic data were successfully collected in 116 patients. Perioperative radial artery graft spasm was observed in 2 patients in the papaverine group and 1 in the verapamil-nitroglycerin group; this difference was not considered significant. Complete or functional occlusion was detected by postoperative angiography in 13 grafts (10 in the papaverine group and 3 in the verapamil-nitroglycerin group). Multivariate regression analysis revealed that topical papaverine and grafting to the right coronary artery significantly increased the rate of occlusion of radial artery grafts. Although further studies are needed, our data support the view that topical verapamil-nitroglycerin reduces the incidence of radial artery graft occlusion.
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Yoshizaki et al. (2008) conducted a cohort in Coronary artery bypass grafting using a radial artery (n=215). Topical verapamil-nitroglycerin vs. Topical papaverine was evaluated on Complete or functional occlusion of radial artery grafts. Topical verapamil-nitroglycerin significantly reduced the incidence of radial artery graft occlusion compared to papaverine (3 vs 10 occlusions) following coronary artery bypass.
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