Smartphone Assessment Prior Radial Artery Harvesting for CABG
- Conditions
- Coronary Artery Disease
- Registration Number
- NCT03810729
- Lead Sponsor
- Ottawa Heart Institute Research Corporation
- Brief Summary
Coronary artery bypass graft (CABG) surgery is a procedure where surgeons use blood vessels from elsewhere in the body to go around blockages or narrowings in the heart arteries. Before the surgery, the surgeon needs to choose which vessel will be used for the bypass, including potentially the radial artery in the wrist. Smartphones have been shown in a previous study to be a better way to assess the arteries in the hand than the traditional physical examination, as it is less subjective than simply watching the flushing of the hand. In this study, the investigators will assess the utility of a smartphone application in determining whether there is enough blood flow in the hand prior to using the radial artery for CABG surgery.
- Detailed Description
Coronary artery bypass graft (CABG) surgery is a procedure where surgeons use blood vessels from elsewhere in the body to go around blockages or narrowings in the heart arteries. Before the surgery, the surgeon needs to choose which vessel will be used for the bypass, including potentially the radial artery in the wrist. Before using this artery, it is important to ensure that there is enough blood flow to the hand to prevent complications. The best way to do this involves the use of ultrasound, but this takes a long time and its availability can be limited. Therefore, the assessment is usually done at the bedside by examining the hand, which relies on the doctor watching the flushing of the hand during compression and release of the artery. Currently, smartphones with cameras are able to assess blood flow by passing light through the skin and observing differences in brightness. This has been shown in a previous study to be a better way to assess the arteries in the hand than the traditional examination, as it is less subjective than simply watching the flushing of the hand. In this study, the investigators will assess the utility of a smartphone application in determining whether there is enough blood flow in the hand prior to using the radial artery for CABG surgery.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 236
- Age greater than or equal to 18 years old
- Scheduled to undergo coronary artery bypass graft for which the surgeon is considering the use of a radial artery conduit
- Able and willing to provide written informed consent
- Hemodynamic instability
- Need for emergent cardiac surgery
- Known previous removal of the radial or ulnar arteries
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Number of participants with use of the radial artery as a conduit for CABG In-hospital (average of 7 days) The primary outcome of this study is the use of the radial artery as a conduit in CABG surgery, which will only occur if the ulnar artery is deemed patent by the corresponding test to which the participant has been randomized to receive (i.e. modified Allen's test or smartphone assessment).
- Secondary Outcome Measures
Name Time Method Number of participants with early graft failure In-hospital (average of 7 days) Early graft failure as determined by angiography during index hospitalization or by need for rescue percutaneous coronary intervention in the immediate post-operative period
Number of participants with stroke In-hospital (average of 7 days) Stroke as determined by an attending neurologist
Number of participants with myocardial infarction In-hospital (average of 7 days) Myocardial infarction as defined by the fourth universal definition of myocardial infarction.
Number of participants with post-operative hand ischemia In-hospital (average of 7 days) Post-operative hand ischemia as determined by clinical assessment by attending physician or by need for a vascular intervention during index hospital admission.
Number of participants with cardiovascular death In-hospital (average of 7 days) Death from cardiovascular cause as determined by attending physician.
Trial Locations
- Locations (1)
University of Ottawa Heart Institute
🇨🇦Ottawa, Ontario, Canada
University of Ottawa Heart Institute🇨🇦Ottawa, Ontario, Canada