title: 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.
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.
authors.affiliation: Department of Cardiovascular Surgery, Gaziantep University School of Medicine, Universite Blv. 27310, Sahinbey/Gaziantep, Turkey. hustunsoy@yahoo.com
authors.forename: Hasim
authors.initials: H
authors.lastname: Ustunsoy
authors.forename: Hakki
authors.initials: H
authors.lastname: Kazaz
authors.forename: M Adnan
authors.initials: MA
authors.lastname: Celkan
authors.forename: Hale
authors.initials: H
authors.lastname: Deniz
authors.forename: Vedat
authors.initials: V
authors.lastname: Davutoglu
authors.forename: Kemal
authors.initials: K
authors.lastname: Bakir
authors.forename: Nihat
authors.initials: N
authors.lastname: Cine
authors.forename: Oktay
authors.initials: O
authors.lastname: Burma
mesh_terms: D000792:Angiography; D001783:Blood Flow Velocity; D004110:Diltiazem / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000637:transplantation*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D004110:Diltiazem; D016285:Iloprost