Myers Martin G, Fremes Stephen E
Sunnybrook and Women's College Health Sciences Centre and Department of Medicine, University of Toronto, Ontario, Canada.
Can J Cardiol. 2003 May;19(6):677-81.
The radial artery (RA) is used as an alternative conduit to the traditional saphenous vein bypass graft in some cardiac surgery centres. Despite limited clinical trial data, many centres appear to be using routine drug therapy to prevent spasm of the RA graft in the immediate and late postoperative period.
To determine the proportion of patients in Canadian cardiac surgery centres having RA bypass grafts and the percentage of patients routinely receiving drug therapy to prevent spasm of these grafts.
A questionnaire was sent to all cardiac surgery centres in Canada requesting data for the year 2000 on the total number of bypass surgery operations and the number of patients having RA bypass grafts. Information on approaches taken toward prophylaxis against spasm of RA grafts was also requested.
The use of RA grafts ranged between 1% and 50%. Twenty-five of 27 centres used antispasm prophylaxis with calcium channel blockers with or without long acting nitrates both in the intensive care unit and on the surgical ward. Calcium channel blockers were prescribed routinely in all 25 centres with 12 centres also using long acting nitrates. Only two centres routinely continued nitrates on the ward. The duration of antispasm therapy varied from several weeks up to six months.
Prophylaxis against spasm of RA grafts is practised in over 95% of Canadian surgical centres despite limited clinical outcome data to support this practice.
在一些心脏外科中心，桡动脉（RA）被用作传统大隐静脉旁路移植的替代管道。尽管临床试验数据有限，但许多中心似乎在术后即刻及晚期使用常规药物治疗来预防RA移植物痉挛。
确定加拿大心脏外科中心接受RA旁路移植的患者比例以及常规接受药物治疗以预防这些移植物痉挛的患者百分比。
向加拿大所有心脏外科中心发送了一份问卷，要求提供2000年旁路手术总例数及接受RA旁路移植患者例数的数据。还要求提供预防RA移植物痉挛所采取方法的信息。
RA移植物的使用率在1%至50%之间。27个中心中有25个在重症监护病房和外科病房使用钙通道阻滞剂联合或不联合长效硝酸盐进行抗痉挛预防。25个中心均常规开具钙通道阻滞剂，其中12个中心还使用长效硝酸盐。只有两个中心在病房常规继续使用硝酸盐。抗痉挛治疗的持续时间从数周到六个月不等。
尽管支持这种做法的临床结果数据有限，但加拿大超过95%的外科中心都在进行RA移植物痉挛的预防。
