To study the prevention of occlusion of aortocoronary-artery bypass grafts, we concluded a prospective, randomized, double-blind trial comparing long-term administration of dipyridamole (begun two days before operation) plus aspirin (begun seven hours after operation) with placebo in 407 patients. Results at one month showed a reduction in the rate of graft occlusion in patients receiving dipyridamole and aspirin. At vein-graft angiography performed in 343 patients (84 per cent) 11 to 18 months (median, 12 months) after operation, 11 per cent of 478 vein-graft distal anastomoses were occluded in the treated group, and 25 per cent of 486 were occluded in the placebo group. The proportion of patients with one or more distal anastomoses occluded was 22 per cent of 171 patients in the treated group and 47 per cent of 172 in the placebo group. All grafts were patent within a month of operation in 94 patients in the placebo group and 116 patients in the treated group; late development of occlusions was reduced from 27 per cent in the placebo group to 16 per cent in the treatment group. The results show that dipyridamole and aspirin continue to be effective in preventing vein-graft occlusion late after operation, and we believe that such treatment should be continued for at least one year.
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[Abstract][Full Text]
Corbineau, H., Lebreton, H., Langanay, T., Logeais, Y., Leguerrier, A.
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[Abstract][Full Text]
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[Abstract][Full Text]
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1: 282-287
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[Abstract][Full Text]
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(1995). Adjunctive Coronary Endarterectomy: Improved Safety in Modern Cardiac Surgery. Ann. Thorac. Surg.
60: 1749-1754
[Abstract][Full Text]
Soyombo, A. A., Angelini, G. D., Newby, A. C.
(1995). Neointima formation is promoted by surgical preparation and inhibited by cyclic nucleotides in human saphenous vein organ cultures. J. Thorac. Cardiovasc. Surg.
109: 2-12
[Abstract][Full Text]
Rajah, S. M., Nair, U., Rees, M., Saunders, N., Walker, D., Williams, G., Critchley, A., Beton, D., Campbell, C., Lawson, R. A., Rahman, A., Nair, K. K., Dyet, J., Kushwaha, S., Rees, A., Powell, J. D., Drake, J.
(1994). Effects of antiplatelet therapy with indobufen or aspirin-dipyridamole on graft patency one year after coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg.
107: 1146-1153
[Abstract][Full Text]
(1994). Collaborative overview of randomised trials of antiplatelet therapy - II: Maintenance of vascular graft or arterial patency by antiplatelet therapy. BMJ
308: 159-168
[Abstract][Full Text]
Antiplatelet Trialists,
(1994). Collaborative overview of randomised trials of antiplatelet therapy Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ
308: 81-106
[Abstract][Full Text]
Cooke, J. P, Creager, M. A
(1991). Management of the patient with intermittent claudication. Vasc Med
2: 19-31
Heiss, H.W., Just, H., Middleton, D., Deichsel, G.
(1990). Reocclusion Prophylaxis with Dipyridamole Combined with Acetylsalicylic Acid Following PTA. ANGIOLOGY
41: 263-269
[Abstract]
Clagett, G. P.
(1990). Antithrombotic Drugs and Vascular Surgery. PERSPECT VASC SURG ENDOVASC THER
3: 79-102
Imperial, E. S
(1987). Approach to cardiac rehabilitation. Clin Rehabil
1: 203-210
[Abstract]
Muller, R., Musikic, P.
(1987). Hemorheology in Surgery A Review. ANGIOLOGY
38: 581-592
[Abstract]
Satiani, B.
(1985). A Prospective Randomized Trial of Aspirin in Femoral Popiteal and Tibial Bypass Grafts. ANGIOLOGY
36: 608-616
[Abstract]
