WFRF:(Geijer Håkan)
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Pedicled versus skeletonized internal thoracic artery grafts : a randomized trial
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- Dreifaldt, Mats, 1959- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiovascular and Thoracic Surgery
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- Samano, Ninos, 1972- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiothoracic and Vascular Surgery and University Health Care Research Center
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- Geijer, Håkan, 1961- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Radiology
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- (creator_code:org_t)
- 2020-12-17
- 2021
- Engelska.
- Ingår i: Asian cardiovascular & thoracic annals. - : Medikaru Toribyun. - 1816-5370 .- 0218-4923. ; 29:6, s. 490-497
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- OBJECTIVE: Concerns have been raised regarding whether skeletonization of the internal thoracic artery could damage the graft and thereby reduces its patency. The objective of this study was to compare patency rates at mid- and long-term follow-up between pedicled and skeletonized left internal thoracic artery grafts.METHODS: This randomized controlled trial included 109 patients undergoing coronary artery bypass surgery. The patients were assigned to receive either one pedicled or one skeletonized left internal thoracic artery graft to the left anterior descending artery. Follow-up was performed at 3 years with conventional angiography, and at 8 years with computed tomography angiography. Differences between patency rates were analyzed with Fisher's exact test and a generalized linear model.RESULTS: The patency rates for pedicled and skeletonized left internal thoracic artery grafts were 46/48 (95.8%) versus 47/52 (90.4%), p = 0.44 at 3 years, and 40/43 (93.0%) versus 37/41 (90.2%), p = 0.71 at 8 years, respectively. The difference in patency rates for pedicled and skeletonized grafts was 5.4% (95% confidence interval: -4.2-14.5) at 3 years and 2.8% (95% confidence interval: -9.9-14.1) at 8 years. All failed grafts, except for one with a localized stenosis, were anastomosed to native coronary arteries with a stenosis less than 70%. Three patients suffered sternal wound infections (two in the pedicled group, one in the skeletonized group).CONCLUSIONS: The skeletonization technique can be used without jeopardizing the patency of the left internal thoracic artery. The most important factor in graft failure was target artery stenosis below 70%.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Coronary artery bypass
- graft occlusion
- saphenous vein
- thoracic arteries
- tissue
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Asian cardiovascular & thoracic annals (Sök värdpublikationen i LIBRIS)
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