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Long-term results of the radial artery used for myocardial revascularization
Gianfederico Possati1, Mario Gaudino, Francesco Prati
1Department of Cardiac Surgery, Catholic University, Rome, Italy. possati@tiscali.it
Insights
Radial artery (RA) grafts show excellent long-term patency in coronary artery bypass surgery, comparable to other grafts. Proper surgical technique and patient selection are crucial for optimal outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Interventional Cardiology
Background:
- Limited data exists on the long-term efficacy of radial artery grafts in coronary artery bypass procedures.
- The radial artery is increasingly considered as a potential conduit for coronary artery bypass grafting.
Purpose of the Study:
- To evaluate the long-term angiographic results and patency rates of radial artery grafts used in coronary artery bypass surgery.
- To identify factors influencing the long-term success of radial artery grafts.
Main Methods:
- A series of 90 consecutive patients undergoing coronary artery bypass grafting with radial artery conduits were analyzed.
- Long-term angiographic follow-up (105+/-9 months) was performed to assess graft patency.
- Factors such as target vessel stenosis, location, and medication use were evaluated for their impact on outcomes.
Main Results:
- Radial artery grafts demonstrated a long-term patency rate of 91.6% and a perfect patency rate of 88%.
- These rates were comparable to internal thoracic artery grafts (97.5% patency, 96.3% perfect patency).
- Severity of target vessel stenosis significantly impacted RA graft patency; vessel location and calcium channel blocker use did not.
Conclusions:
- Radial artery grafts offer excellent long-term patency and functional results up to 10 years post-surgery.
- Appropriate surgical technique and careful patient selection are paramount for achieving sustained radial artery graft patency.
- Preserved endothelial function and absence of significant intimal hyperplasia were noted in the studied radial artery grafts.
Background:
No information is available on the long-term results of radial artery (RA) grafts used as coronary artery bypass conduits.
Methods And Results:
In this report, we describe the long-term (105+/-9 months) angiographic results of a series of 90 consecutive patients in whom the RA was used as a coronary artery bypass conduit directly anastomosed to the ascending aorta. The long-term patency and perfect patency rates of the RA were 91.6% and 88%, respectively, versus 97.5% and 96.3% for internal thoracic artery grafts. The severity of stenosis of the target vessel clearly influenced long-term RA patency, whereas location of the target vessel and long-term use of calcium channel blockers did not influence angiographic results. Preserved endothelial function and absence of flow-limiting, fibrous, intimal hyperplasia were also documented.
Conclusions:
Ten years after surgery, RA grafts have excellent patency and perfect patency rates. Appropriate surgical technique and correct indication are the key factors for long-term RA patency.
