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Use of the radial artery graft after transradial catheterization: is it suitable as a bypass conduit?

Hiroyuki Kamiya1, Teruaki Ushijima, Taro Kanamori

  • 1Department of Cardiovascular Surgery, Maizuru Mutual Hospital, Hama, Maizuru, Japan. h.kamiya@triton.ocn.ne.jp

The Annals of Thoracic Surgery
|November 7, 2003
PubMed

Insights

Transradial catheterization negatively impacts radial artery graft patency and increases intimal hyperplasia in coronary artery bypass grafting. Surgeons should use the radial artery cautiously after this procedure.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Grafting
  • Interventional Cardiology

Background:

  • The radial artery is a common choice for bypass grafting in coronary artery bypass grafting (CABG).
  • Concerns exist regarding the suitability of the radial artery as a bypass conduit following transradial catheterization.
  • Assessing the impact of prior transradial catheterization on radial artery graft outcomes is crucial.

Purpose of the Study:

  • To evaluate the effect of preoperative transradial catheterization on the early patency and histological characteristics of radial artery grafts used in coronary artery bypass grafting.
  • To compare the outcomes of radial artery grafts in patients with and without prior transradial catheterization.

Main Methods:

  • Retrospective review of 67 patients undergoing isolated coronary artery bypass grafting using the radial artery.
  • Patients were divided into two groups: 22 with preoperative transradial catheterization (group 1) and 45 without (group 2).
  • Comparison of stenosis-free graft patency rates and incidence of intimal hyperplasia between the groups.

Main Results:

  • No significant differences in patient characteristics, operative procedures, or early clinical outcomes were observed between the groups.
  • Radial artery grafts showed significantly lower stenosis-free patency rates in patients with prior transradial catheterization (77%) compared to those without (98%) (p = 0.017).
  • A higher incidence of intimal hyperplasia was found in radial artery grafts from patients with prior transradial catheterization (68%) versus those without (39%) (p = 0.046).

Conclusions:

  • Preoperative transradial catheterization is associated with reduced early graft patency and increased intimal hyperplasia of the radial artery when used for coronary artery bypass grafting.
  • Despite these findings, transradial catheterization did not adversely affect early clinical outcomes.
  • The use of the radial artery as a bypass conduit subsequent to transradial catheterization warrants cautious consideration by surgeons.
Abstract

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