Clinical Research Directory

Fasciotomy and Predilation for Radial Artery Grafts in CABG

The goal of this clinical trial is to learn if a new way to prepare a radial artery graft during coronary artery bypass grafting (CABG) can improve outcomes for adults having this surgery. CABG is a heart surgery that uses a blood vessel to bypass blocked arteries in the heart. The radial artery is a blood vessel taken from the arm and used as a graft. The new way combines two steps: Fasciotomy: a small cut in the tissue around the graft to release pressure. Predilation: gently filling the graft with a medicine solution to widen it and check for damage. Researchers will compare this new way with the standard way of harvesting the radial artery. The main questions it aims to answer are: Does the new way lower the chance of death, heart attack, another procedure to restore blood flow through the graft, or graft failure within 1 year after surgery? Does it improve blood flow and keep the radial artery graft open? Is it safe? Participants will: Be adults scheduled to have CABG using a radial artery graft. Be assigned by chance to one of two groups: the new way or the standard way. Have CABG surgery. Visit the clinic at 7 days, 30 days, 6 months, and 12 months after surgery. Have a special heart scan (coronary computed tomography angiography, CCTA) at 7 days and 12 months to check the graft. Allow researchers to collect medical information and record any health problems. Researchers will compare the two groups to see if the new way works better than the standard way.

Different Anti-Spastic Therapy Strategies After CABG Using Radial Artery Grafts

The Pilot study will be a single-center, randomized, open-label, active-controlled trial. After CABG surgery using Radial Artery Grafts (RA-CABG) and signing the informed consent, all patients will be screened according to the inclusion and exclusion criteria. Estimated 150 patients will be enrolled and randomized by ratio 1:1:1 to receive either Nicorandil (5mg tid po) or Diltiazem (180mg qd po) or Isosorbide Mononitrate (50mg qd po). Follow-up visits will be conducted at Week 1, 4, 12, and 24 after surgery. The last evaluation of study endpoints and other adverse events will be at Week 24. The pilot study is designed to explore the angiography outcomes of grafts and cardiovascular outcomes of patients, as well as safety outcomes among different anti-spastic regimens after RA-CABG. The original study plan included a 24-week follow-up to evaluate the effects of different antispasmodic medications on radial artery grafts. The study protocol has been updated to include a centralized follow-up at a median of 5 years post-surgery. During this follow-up, patients' survival status, imaging results of graft vessels, and major cardiovascular events will be collected via outpatient visits or telephone interviews, with the aim of evaluating the impact of different antispasmodic strategies on long-term clinical outcomes and graft patency.