The Pneumatic Tourniquet Technique for Endoscopic Radial Artery Harvest; Does it Affect Patient Hemodynamics?
NCT ID: NCT05349773
Last Updated: 2022-08-05
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
32 participants
OBSERVATIONAL
2022-05-19
2022-08-01
Brief Summary
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Detailed Description
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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).
Conditions
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Study Design
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CASE_ONLY
PROSPECTIVE
Study Groups
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endoscopic left radial artery harvesting
single group of 32 patients listed for coronary artery bypass surgery with endoscopic radial artery harvesting.
Pneumatic tourniquet, endoscopic left radial artery harvesting
Endoscopic radial artery harvesting technique is performed after applying a tourniquet over the distal arm proximally to the elbow. The tourniquet pressure is increased 90 mmHg over the systolic pressure and the tourniquet time will be monitored.
he changes in Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) will be assessed before and after deflating the tourniquet every 5 minutes for 30 minutes.
Interventions
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Pneumatic tourniquet, endoscopic left radial artery harvesting
Endoscopic radial artery harvesting technique is performed after applying a tourniquet over the distal arm proximally to the elbow. The tourniquet pressure is increased 90 mmHg over the systolic pressure and the tourniquet time will be monitored.
he changes in Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) will be assessed before and after deflating the tourniquet every 5 minutes for 30 minutes.
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* CABG plus any other cardiac surgery.
* The use of inopressor drugs before ERAH
30 Years
80 Years
ALL
No
Sponsors
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Mansoura University
OTHER
Responsible Party
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Principal Investigators
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Elsayed M Abdelkarime, MD
Role: STUDY_CHAIR
Lecturer of Anesthesia and Surgical Intensive Care
Ahmed A Eisa, MD
Role: STUDY_DIRECTOR
Lecturer of Anesthesia and Surgical Intensive Care
Locations
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Mansoura University
Al Mansurah, DK, Egypt
Countries
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Other Identifiers
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MFM-IRB, R.22.02. 1615.R1
Identifier Type: -
Identifier Source: org_study_id
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