EORNA2022_Abstract Book

Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress ePosters 55 eP13 Validity and reliability of radial artery assessment techniques in coronary artery bypass grafting: a systematic review V. De Franco1 1Royal Papworth Hospital NHS Foundation Trust, Operating Theatre Department, Cambridge, United Kingdom Objectives: Accuracy and consistency of screening tests implemented for the pre-operative assessment of radial artery (RA) graft, prior to surgical coronary revascularisation, has been at the heart of debate for many years. Correct RA assessment is crucial prior their surgical harvesting to avoid post-operative complications. However, the absence of a universally agreed approach emphasises the lack of evidence-based practice. A systematic review was conducted with the aim of evaluating and comparing the validity and reliability of the most commonly adopted RA assessment techniques, including: modified Allen test (MAT), pulse-oximetry, plethysmography and ultrasonography. The objective of this research was identified as the need to establish the most superior RA screening test within cardiac institutions. Methods: A systematic search was undertaken, appraising relevant primary research studies published in English between 2010 and 2020. MEDLINE, PubMed, CINHAL, Scopus and EMBASE databases were consulted, to access studies relating to the assessment of RAs during coronary artery bypass grafting. All included articles were reviewed and selection criteria applied, data findings were extracted for analysis, narrative synthesis and conclusions drawn. Critical appraisal of the included studies was performed using the modified Downs and Black checklist. Results: Nine studies addressing the research question were included in the review. Seven studies identified the reduced validity and/or reliability of the MAT, four of which highlighted the poor sensitivity, poor specificity and the subjectivity of the screening test. Two studies established that pulse-oximetry and plethysmography, used in combination with the MAT, offer more objective results than an isolated MAT, also impacting on sensitivity and specificity. Ultrasonography provides important insight into the morphological characteristics of RAs, providing an accurate and reliable anatomical RA assessment. Conclusions: This systematic review suggests that ultrasonography screening is superior in RA assessment, enabling selection of RA segments with favourable morphological features, hence optimising post-operative surgical outcomes. eP14 Angioplasty of the peripheral arteries in peripheral arterial disease A. Kavga1, A. Misisian1 1Athens Medical Center, Athens, Greece The etiology of peripheral arterial disease (PAD) is the stenosis or occlusion of the femoropopliteal arteries through atherosclerosis. Main risk factors are age > 60 years, tobacco use, arterial hypertensions and metabolic syndrome. Diabetic patients carry an additional risk for the most severe form of PAD, i.e. critical limb ischemia. The treatment of the stenosis or occlusion of the peripheral arteries require recanalization of the lesion through advancement of dedicated wires under fluoroscopy. It follows the introduction of the balloon catheter and the dilatation of the lesion. This is called angioplasty. The effect of angioplasty is to open the vessel lumen by stretching and pushing the plaque outwards. In the majority of the cases, the lumen gain is good enough to establish adequate perfusion of the limb. In some cases, recoil or dissection of the plaque may jeopardize the blood flow and additional scaffolding with bare metal stents is necessary. In the current days, the addition of paclitaxel on the surface of the balloons or stents has reduced dramatically the restenosis rate with excellent angiographic and clinical results. In summary, angioplasty is a minimally invasive treatment strategy of the peripheral arterial disease an provides the unique opportunity to the patient to return quickly back to the daily practice.

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