Akademik Veri Yönetim Sistemi
Turkish journal of vascular surgery, cilt.14, sa.2, ss.7-12, 2005 (Hakemli Dergi)
Amaç: Bu çal›flmada koroner arter baypas cerrahisinde (KABC) radiyal arter (RA) kullan›m›n›n, RA ç›kar›lan önkoldaki arteriyel dolafl›ma etkisi ve preoperatif dönemde, önkol arteriyel dolafl›m›ndaki dominans›n belirlenmesi amaçlanm›flt›r.
Yöntem: 0cak 2003 ile Ocak 2005 tarihleri aras›nda, KABC’de RA kullan›lan, 52 hasta (40 erkek, 12 kad›n) çal›flmaya dahil edildi. Hastalar›n ortalama yafl› 56 ± 7 y›l idi. RA ç›kar›lan önkoldaki arteriyel dolafl›m, preoperatif dönemde ve operasyondan sonraki birinci y›lda, renkli ak›m Doppler ultrasonografi ile de¤erlendirildi.
Bulgular: Ulnar arterin (UA) ortalama kesit alan› preoperatif dönemde 5.3 mm2 iken, postopertif dönemde belirgin olarak yükselerek 5.8 mm2 oldu (p=0.005). UA’deki ortalama tepe sistolik h›z›, preoperatif dönemde 58.9 cm/sn iken, postoperatif dönemde 73.9 cm/sn oldu (p<0.001). Preoperatif dönemde, RA ve UA’da ki ortalama kan ak›m› s›ras› ile 60.2 ml/dak ve 60.4 ml/dak bulundu. Postoperatif dönemde, UA’da ki ortalama kan ak›m› belirgin olarak yükselerek, 105 ml/dak oldu. Hastalar›n bir y›ll›k takiplerinde, iki hastan›n parmak uçlar›ndaki minimal parestezi gerilemedi. Bunun d›fl›nda iskemik semptoma rastlanmad›. Sonuçlar: Postoperatif dönemde, RA ç›kar›lan önkoldaki UA’n›n artan ortalama kan ak›m› (105 ml/dak), preoperatif dönemdeki UA ve RA’n›n ortalama kan ak›mlar› toplam›ndan (120.6 ml/dak) daha düflük bulundu. Fakat, bu fark istatistiksel olarak anlaml› bulunmad›. Elde hiçbir iskemik komplikasyona rastlanmad›. KABC’de RA kullan›lmas›, elin kan ak›m›n› tehlikeye sokmamakta ve seçilmiflhastalarda güvenle kullan›labilmektedir. (Damar Cer Der 2005;14(2):7-12).
Purpose: The aim of this study is to evaluate the forearm artery circulation preoperatively to identify arterial dominance into the hand and to describe the effects of radial artery (RA) harvest on the forearm blood flow in the harvested forearm, postoperatively. Methods: Between January 2003 and January 2005, a total of 52 patients (40 male, 12 female) scheduled for RA harvest in CABG. Mean age was 56 ± 7 years. They were evaluated preoperatively and one year after RA harvest by color flow Doppler ultrasonography for forearm artery circulation in the harvested forearm.
Results: In the evaluation of the ulnar artery (UA); the mean cross-sectional area was 5.3 mm2 preoperatively and significantly increased to 5.8 mm2 postoperatively (p=0.005). The mean peak systolic velocity in the UA significantly increased preoperatively to postoperatively, from 58.9 cm/sec to 73.9 cm/sec (p<0.001). Preoperatively the mean blood flow in the RA was 60.2 ml/min and in the UA was 60.4 ml/min and postoperatively in the UA significantly rose to 105 ml/min. After one year follow-up, the patients were not complaining of any ischemic symptoms except minimal paresthesia at the fingertips in 2 patients.
Conclusion: The postoperative mean blood flow in the UA (105 ml/min), which increases to compensate the harvested RA, is lower than the preoperative total mean blood flow in the sum of the RA and the UA (120.6 ml/min), however the difference is not statistically significant. There was no ischemic complication of the hand. Blood flow to the hand will not be compromised by RA harvest and can be performed safely in selected patients. (Turkish J Vasc Surg 2005;14(2):7-12).