HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Michael J. Shackcloth Aung Y. Oo Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Conant, A. R. Articles by Dihmis, W. C. Search for Related Content PubMed PubMed Citation Articles by Conant, A. R. Articles by Dihmis, W. C. Related Collections Cardiac - pharmacology Coronary disease

J Thorac Cardiovasc Surg 2003;126:448-454
© 2003 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Phenoxybenzamine treatment is insufficient to prevent spasm in the radial artery: the effect of other vasodilators

^a Cardiothoracic Centre,^a Liverpool NHS Trust, Liverpool, UK
^b Department Human Anatomy and Cell Biology,^b University of Liverpool, New Medical School, Liverpool, United Kingdom

Received for publication September 24, 2002; revisions received October 25, 2002; revisions received November 8, 2002; accepted for publication November 11, 2002.

^* Address for reprints: Alan Conant, PhD, The Cardiothoracic Centre, Liverpool NHS Trust, Thomas Drive, Liverpool L14 3PE, United Kingdom
Alan.Conant{at}ctc.NHS.uk

OBJECTIVES: After its reintroduction as an arterial graft in coronary artery surgery, the radial artery is now established as an alternative arterial conduit, with good early and midterm patency. However, because of the concern about its vasospasticity, numerous vasodilator strategies have been used. Recently the use of the irreversible -adrenergic antagonist phenoxybenzamine has been proposed. Although this treatment is effective in eliminating the vasoconstriction mediated by noradrenaline, the contribution of other circulating vasoconstrictors to vasospasm could be as important. This study investigates the response of radial arteries treated with phenoxybenzamine to vasoconstrictor stimuli and possible preventative strategies.

METHODS: In vitro, sections of radial artery, pretreated with phenoxybenzamine after harvesting, were stimulated with maximal concentrations of the vasoconstrictors noradrenaline, vasopressin, angiotensin II, KCl, and endothelin-1. In matched segments of artery, vasoconstrictor responses were recorded in the presence of diltiazem, glyceryl trinitrate, and papaverine and compared with phenoxybenzamine-treated samples.

RESULTS: Phenoxybenzamine-treated radial artery failed to respond to noradrenaline but did respond to vasopressin, angiotensin II, endothelin-1, and KCl. Diltiazem was largely ineffective against contractile stimuli apart from KCl. Glyceryl trinitrate and papaverine significantly reduced responses to all of the vasoconstrictors tested.

CONCLUSION: In phenoxybenzamine-treated sections of radial artery, circulating vasoconstrictor agonists may still contribute to the induction of spasm. Additional vasodilator strategies may be required to completely prevent vasospasm.

This article has been cited by other articles:

				M. J. Shackcloth, A. R. Conant, J. Thekkudan, S. Ghotkar, A. W.M. Simpson, and W. C. Dihmis Attenuation of receptor-dependent and -independent vasoconstriction in the human radial artery Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 839 - 844. [Abstract] [Full Text] [PDF]

				G.-W. He, L. Fan, A. Furnary, and Q. Yang A new antispastic solution for arterial grafting: Nicardipine and nitroglycerin cocktail in preparation of internal thoracic and radial arteries for coronary surgery J. Thorac. Cardiovasc. Surg., September 1, 2008; 136(3): 673 - 680. [Abstract] [Full Text] [PDF]

				H. B. Barner Operative Treatment of Coronary Atherosclerosis Ann. Thorac. Surg., April 1, 2008; 85(4): 1473 - 1482. [Abstract] [Full Text] [PDF]

				S. Attaran, L. John, and A. El-Gamel Clinical and Potential Use of Pharmacological Agents to Reduce Radial Artery Spasm in Coronary Artery Surgery Ann. Thorac. Surg., April 1, 2008; 85(4): 1483 - 1489. [Abstract] [Full Text] [PDF]

				I. A. Tarhan, T. Kehlibar, Y. Arslan, M. Yilmaz, M. Dumantepe, K. Berkoz, C. Pancaroglu, and A. Ozler Effects of normothermic organ bath and verapamil nitroglycerin solution alone or in combination on the blood flow of radial artery Eur. J. Cardiothorac. Surg., October 1, 2007; 32(4): 617 - 622. [Abstract] [Full Text] [PDF]

				A. Kulik, F. D. Rubens, D. Gunning, M. E. Bourke, T. G. Mesana, and M. Ruel Radial Artery Graft Treatment With Phenoxybenzamine is Clinically Safe and May Reduce Perioperative Myocardial Injury Ann. Thorac. Surg., February 1, 2007; 83(2): 502 - 509. [Abstract] [Full Text] [PDF]

				A. Y. Oo, A. R. Conant, M. R. Chester, W. C. Dihmis, and A. W.M. Simpson Temperature Changes Stimulate Contraction in the Human Radial Artery and Affect Response to Vasoconstrictors Ann. Thorac. Surg., January 1, 2007; 83(1): 126 - 132. [Abstract] [Full Text] [PDF]

				K. Iino, S. Tomita, K. Higashidani, T. Ujiie, S. Arai, and G. Watanabe Successful Coronary Revascularization Using the PAS-Port System in a Patient With Takayasu's Arteritis and Behcet's Disease Ann. Thorac. Surg., November 1, 2006; 82(5): 1889 - 1891. [Abstract] [Full Text] [PDF]

				A. A. Frazier, F. Qureshi, K. M. Read, R. C. Gilkeson, R. S. Poston, and C. S. White Coronary Artery Bypass Grafts: Assessment with Multidetector CT in the Early and Late Postoperative Settings RadioGraphics, July 1, 2005; 25(4): 881 - 896. [Abstract] [Full Text] [PDF]

				F. Kerendi, M. E. Halkos, J. S. Corvera, H. Kin, Z.-Q. Zhao, M. Mosunjac, R. A. Guyton, and J. Vinten-Johansen Inhibition of myosin light chain kinase provides prolonged attenuation of radial artery vasospasm Eur. J. Cardiothorac. Surg., December 1, 2004; 26(6): 1149 - 1155. [Abstract] [Full Text] [PDF]

				S. G. Raja, I. Tsuneyoshi, R. Katai, J. Hamasaki, M. Onomoto, and Y. Kanmura Dopamine and Radial Artery: Implications for Clinical Practice * Response Anesth. Analg., November 1, 2004; 99(5): 1575 - 1575. [Full Text] [PDF]