verapamil and Graft Occlusion, Vascular studies

Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent.
verapamil : A racemate comprising equimolar amounts of dexverapamil and (S)-verapamil. An L-type calcium channel blocker of the phenylalkylamine class, it is used (particularly as the hydrochloride salt) in the treatment of hypertension, angina pectoris and cardiac arrhythmia, and as a preventive medication for migraine.
2-(3,4-dimethoxyphenyl)-5-{[2-(3,4-dimethoxyphenyl)ethyl](methyl)amino}-2-(propan-2-yl)pentanenitrile : A tertiary amino compound that is 3,4-dimethoxyphenylethylamine in which the hydrogens attached to the nitrogen are replaced by a methyl group and a 4-cyano-4-(3,4-dimethoxyphenyl)-5-methylhexyl group.

Graft Occlusion, Vascular: Obstruction of flow in biological or prosthetic vascular grafts.

Research Excerpts

Excerpt	Relevance	Reference
" In carefully selected subgroup of SVG lesions without visible macrothrombus, a strategy of prophylactic intra-graft administration of abciximab and verapamil, combined with direct stenting of the graft lesion without pre-dilatation, can be safely accomplished without any significant risk of slow-flow/no-reflow phenomenon."	6.77	Intra-graft abciximab and verapamil combined with direct stenting is a safe and effective strategy to prevent slow-flow and no-reflow phenomenon in saphenous vein graft lesions not associated with thrombus. ( Bhambi, BK; Lardizabal, JA; Sandhu, R; Sharma, S; Singh, S, 2012)
"The potential of the calcium channel antagonist verapamil to cause apoptosis (programmed cell death) is of considerable importance in arterial injury where the loss of smooth muscle cells may contribute to a reduction in intimal hyperplasia development."	3.71	Calcium channel antagonist verapamil inhibits neointimal formation and enhances apoptosis in a vascular graft model. ( Angeli, GL; Fletcher, JP; Hawthorne, WJ; Huang, P; Medbury, HJ; Peng, A, 2001)
" In carefully selected subgroup of SVG lesions without visible macrothrombus, a strategy of prophylactic intra-graft administration of abciximab and verapamil, combined with direct stenting of the graft lesion without pre-dilatation, can be safely accomplished without any significant risk of slow-flow/no-reflow phenomenon."	2.77	Intra-graft abciximab and verapamil combined with direct stenting is a safe and effective strategy to prevent slow-flow and no-reflow phenomenon in saphenous vein graft lesions not associated with thrombus. ( Bhambi, BK; Lardizabal, JA; Sandhu, R; Sharma, S; Singh, S, 2012)
" However, the concentrations at which these calcium channel blockers elicit antiproliferative effects may not be attainable during therapeutic dosing in humans."	1.29	Effect of calcium channel blockers on the growth of human vascular smooth muscle cells derived from saphenous vein and vascular graft stenoses. ( Betteridge, L; Chan, P; Gallagher, K; Munro, E; Patel, M; Schachter, M; Sever, P; Wolfe, J, 1994)

Research

Studies (10)

Authors

Clinical Trials (1)

Trial Overview

Trial Outcomes

Change in Radial Artery Dimension Measured in mm^2.

Timeframe	Studies, this research(%)	All Research%
pre-1990	0 (0.00)	18.7374
1990's	4 (40.00)	18.2507
2000's	5 (50.00)	29.6817
2010's	1 (10.00)	24.3611
2020's	0 (0.00)	2.80

Authors	Studies
Yoshizaki, T	1
Tabuchi, N	1
Toyama, M	1
Sharma, S	1
Lardizabal, JA	1
Singh, S	1
Sandhu, R	1
Bhambi, BK	1
Munro, E	1
Patel, M	1
Chan, P	1
Betteridge, L	1
Gallagher, K	1
Schachter, M	1
Wolfe, J	1
Sever, P	1
Ceceña, FA	1
Hoelzinger, DH	1
Kaplan, BM	1
Benzuly, KH	1
Kinn, JW	1
Bowers, TR	1
Tilli, FV	1
Grines, CL	1
O'Neill, WW	1
Safian, RD	1
Huang, P	1
Hawthorne, WJ	1
Peng, A	1
Angeli, GL	1
Medbury, HJ	1
Fletcher, JP	1
Chanda, J	1
Canver, CC	1
Michaels, AD	1
Appleby, M	1
Otten, MH	1
Dauterman, K	1
Ports, TA	1
Chou, TM	1
Gibson, CM	1
Kereiakes, DJ	1
Young, JJ	1
Choo, JK	1
Broderick, TM	1
Orekhova, NM	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
Topical Nitroglycerine Treatment for Radial Artery Spasm Prevention[NCT02832115]	Phase 4	100 participants (Actual)	Interventional	2016-09-30	Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Change in Radial artery cross sectional area in mm^2 - Before application of topical nitroglycerine / placebo (Pre dilation) vs Prior to arterial puncture after application of topical nitroglycerine / placebo (Post-dilation) (NCT02832115)
Timeframe: Application of nitroglycerine / placebo until prior to arterial puncture. Approximate 60 to 120 minutes

Number of Patients With Procedural Failure

Intervention	mm^2 (Mean)
Study	2.5
Control	-0.2

Need to abort procedure or convert to transfemoral access (NCT02832115)
Timeframe: Intraprocedural: From procedure start to application of radial band. Approximate time 30 to 90 minutes.

Patient Discomfort or Pain During Procedure (Visual Analog Scale 0-10)

Intervention	Participants (Count of Participants)
Study	0
Control	4

Patient discomfort or pain during procedure measured using Visual analog scale 0-10, 0 being no discomfort or pain (best) and 10 being worst discomfort or pain (worst) (NCT02832115)
Timeframe: Intraprocedural: From procedure start to application of radial band. Approximate time 30 to 90 minutes.

Radial Artery Spasm

Intervention	score on a scale (Mean)
Study	0.792
Control	0.875

"Incidence of radial artery spasm indicated by a Radial artery spasm score of 1 or more. Radial artery spasm score is sum of:~Intraprocedural pain in the forearm aggravated by movement of the catheter/sheath - Absent :0; Present:1~Difficulty in manipulating the catheter- Absence :0; Present:1~Difficulty with sheath removal: Absent: 0; Present:1~Additional use of intraarterial nitroglycerine or verapamil after the initial vasodilator cocktail- No:0; Yes:1" (NCT02832115)
Timeframe: Intraprocedural: From procedure start to application of radial band. Approximate time 30 to 90 minutes.

Radial Pulse at End of Procedure

Intervention	Participants (Count of Participants)
Study	8
Control	15

Radial pulse at end of procedure 0- 4+, 0 indicating no palpable pulse (worst); 1 + indicating a faint, but detectable pulse; 2 + suggesting a slightly more diminished pulse than normal; 3 + is a normal pulse; and 4 + indicating a bounding pulse (best). (NCT02832115)
Timeframe: At the end of transradial cardiac catheterization after sheath removal

Article	Year
Intra-graft abciximab and verapamil combined with direct stenting is a safe and effective strategy to prevent slow-flow and no-reflow phenomenon in saphenous vein graft lesions not associated with thrombus. Recent patents on cardiovascular drug discovery, 2012, Volume: 7, Issue:2 Topics: Abciximab; Administration, Intravenous; Aged; Antibodies, Monoclonal; Coronary Vasospasm; Female; Gr	2012
Pretreatment with intragraft verapamil prior to percutaneous coronary intervention of saphenous vein graft lesions: results of the randomized, controlled vasodilator prevention on no-reflow (VAPOR) trial. The Journal of invasive cardiology, 2002, Volume: 14, Issue:6 Topics: Aged; Angioplasty, Balloon, Coronary; Cardiac Catheterization; Coronary Angiography; Female; Graft O	2002

Article	Year
Verapamil and nitroglycerin improves the patency rate of radial artery grafts. Asian cardiovascular & thoracic annals, 2008, Volume: 16, Issue:5 Topics: Administration, Topical; Aged; Coronary Artery Bypass; Drug Combinations; Female; Graft Occlusion, V	2008
Effect of calcium channel blockers on the growth of human vascular smooth muscle cells derived from saphenous vein and vascular graft stenoses. Journal of cardiovascular pharmacology, 1994, Volume: 23, Issue:5 Topics: Amlodipine; Cell Division; Cells, Cultured; Diltiazem; DNA; Graft Occlusion, Vascular; Humans; L-Lac	1994
Transcatheter therapy of thrombotic-occlusive lesions in saphenous vein grafts. The American journal of cardiology, 1996, Jul-01, Volume: 78, Issue:1 Topics: Aged; Combined Modality Therapy; Coronary Angiography; Coronary Artery Bypass; Disease-Free Survival	1996
Treatment of no-reflow in degenerated saphenous vein graft interventions: comparison of intracoronary verapamil and nitroglycerin. Catheterization and cardiovascular diagnosis, 1996, Volume: 39, Issue:2 Topics: Aged; Calcium Channel Blockers; Coronary Angiography; Coronary Artery Bypass; Female; Graft Occlusio	1996
Calcium channel antagonist verapamil inhibits neointimal formation and enhances apoptosis in a vascular graft model. American journal of surgery, 2001, Volume: 181, Issue:6 Topics: Analysis of Variance; Animals; Apoptosis; Calcium Channel Blockers; Carotid Artery, Common; Disease	2001
Reversal of preexisting vasospasm in coronary artery conduits. The Annals of thoracic surgery, 2001, Volume: 72, Issue:2 Topics: Arteries; Calcium Channel Blockers; Coronary Artery Bypass; Coronary Disease; Culture Techniques; Di	2001
Intragraft verapamil: an ounce of prevention is worth a pound of cure. The Journal of invasive cardiology, 2002, Volume: 14, Issue:6 Topics: Angioplasty, Balloon, Coronary; Catheterization; Graft Occlusion, Vascular; Humans; Myocardial Reper	2002
Proliferative and synthetic activity of cells from reoccluded distal anastomosis and pharmacological therapy of this postoperative complication. Agents and actions, 1991, Volume: 32, Issue:1-2 Topics: 1-Methyl-3-isobutylxanthine; Anastomosis, Surgical; Aorta; Arteriosclerosis; Cell Division; Colforsi	1991

verapamil and Graft Occlusion, Vascular