ReviewCureus2025
Comparative Efficacy and Safety of Vasodilators Used to Prevent Internal Thoracic Artery Spasm in Coronary Artery Bypass Grafting: A Systematic Review.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Internal thoracic artery (ITA) spasm during coronary artery bypass grafting (CABG) can compromise graft flow and perioperative outcomes. This review systematically evaluates the comparative efficacy and safety of vasodilators used to prevent ITA spasm, including papaverine, glyceryl trinitrate-verapamil (GV) solution, systemic diltiazem, and efonidipine. Six studies comprising clinical, ex vivo, and in vitro investigations were included. GV solution consistently demonstrated superior vasodilatory efficacy, rapid onset (2.9 min), and high potency, achieving near-complete ITA relaxation and increasing intraoperative free flow by up to 95%, with minimal adverse events. Papaverine effectively prevented spasm at high concentrations but showed a slower onset. Systemic diltiazem improved graft flow safely, while efonidipine exhibited dose-dependent relaxation in ex vivo models, targeting both L- and T-type calcium channels. Delivery method influenced efficacy, with topical or intraluminal administration providing rapid, direct vasodilation. Overall, combination therapy (GV solution) offers a practical and safe approach for intraoperative ITA spasm prevention.
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