Ignite Creation Date:
2024-05-06 @ 5:32 PM
Last Modification Date:
2024-10-26 @ 2:31 PM
Study NCT ID:
NCT05349773
Status:
COMPLETED
Last Update Posted:
2022-08-05
First Post:
2022-04-14
Brief Title:
The Pneumatic Tourniquet Technique for Endoscopic Radial Artery Harvest Does it Affect Patient Hemodynamics
Sponsor:
Mansoura University
Organization:
Mansoura University
Study Overview
Official Title:
The Pneumatic Tourniquet Technique for Endoscopic Radial Artery Harvest Does it Affect Patient Hemodynamics
Status:
COMPLETED
Status Verified Date:
2022-08
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
This study aims to investigate the effect of the pneumatic tourniquet technique on the patients hemodynamics heart rate HR systolic blood pressure SBP and diastolic blood pressure DBP
Detailed Description:
Coronary artery bypass graft surgery CABG is the most common cardiac surgical procedure Radial artery of the non-dominant hand with better ulnar collaterals is preferred over the saphenous vein because of long term patency of the radial artery Radial artery is the preferred second or third arterial conduits for vessels with sub occlusive stenosis
There are two techniques of radial artery harvesting open and endoscopic techniques Endoscopic radial artery harvesting ERAH is increasing and it is possible but the evidence regarding its safety is scarce ERAH is cosmetically better than the open technique
ERAH technique is performed after applying a tourniquet over the distal arm proximally to the elbow Allen test will be done first and if the hand has a good blood supply through the ulnar artery the tourniquet pressure is increased 75-100 mmHg over the systolic pressure and the tourniquet time is kept under one hour and the left radial artery will be endoscopically harvested
During the time of tourniquet inflation there is ischemia of the forearm with subsequent cellular ischemic changes like cellular acidosis cellular edema and activation of cellular apoptosis On deflating the tourniquet there is reperfusion of the limb and development of ischemic reperfusion injury with a subsequent increase of inflammatory mediators and reactive oxygen species ROS These changes may be associated with some hemodynamic instability that might be dangerous especially in patients with ischemic heart disease IHD
There are two techniques of radial artery harvesting open and endoscopic techniques Endoscopic radial artery harvesting ERAH is increasing and it is possible but the evidence regarding its safety is scarce ERAH is cosmetically better than the open technique
ERAH technique is performed after applying a tourniquet over the distal arm proximally to the elbow Allen test will be done first and if the hand has a good blood supply through the ulnar artery the tourniquet pressure is increased 75-100 mmHg over the systolic pressure and the tourniquet time is kept under one hour and the left radial artery will be endoscopically harvested
During the time of tourniquet inflation there is ischemia of the forearm with subsequent cellular ischemic changes like cellular acidosis cellular edema and activation of cellular apoptosis On deflating the tourniquet there is reperfusion of the limb and development of ischemic reperfusion injury with a subsequent increase of inflammatory mediators and reactive oxygen species ROS These changes may be associated with some hemodynamic instability that might be dangerous especially in patients with ischemic heart disease IHD
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None