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Published on: September 20, 2020
[Does transradial cardiac catheterization affect coronary artery bypass grafting?]
Azumi Hamasaki1, G Yaginuma, S Watanabe
1Department of Cardiovascular Surgery, Kousei Hospital, Sendai, Japan.
Insights
The transradial approach for cardiac catheterization may affect radial artery grafts used in coronary artery bypass grafting (CABG). However, most graft issues were localized, and graft patency remained unaffected, ensuring suitability for future use.
Area of Science:
- Cardiology
- Vascular Surgery
Context:
- Minimally invasive cardiac procedures are advancing.
- The transradial approach for cardiac catheterization offers benefits like fewer complications and improved patient satisfaction.
- Concerns exist regarding the impact of transradial catheterization on radial artery grafts used for coronary artery bypass grafting (CABG).
Purpose:
- To evaluate the influence of transradial catheterization on the condition and patency of radial artery grafts used in CABG.
Summary:
- A retrospective study analyzed 157 patients who underwent CABG with radial artery grafts.
- Graft condition was assessed intraoperatively, and patency was evaluated via postoperative coronary angiography 3 months post-intervention.
- Approximately 25% of radial artery grafts showed effects from transradial catheterization, primarily at the puncture site.
Impact:
- Most affected grafts were salvageable by resecting the distal end, allowing continued use for grafting.
- Transradial catheterization did not negatively impact the overall patency rate of radial artery grafts used in CABG.
Abstract:
Recent technological advances have enabled the miniaturization of catheters for coronary angiography and intervention. As a result of this advancement, the transradial approach is becoming more popular. The advantages of this approach include a lower incidence of access site complications, earlier patient ambulation, improved patient satisfaction, and lower cost. The cardiologists of our institute have introduced this technique without delay and have taken the initiative in Japan. However, there are concerns regarding the effect of transradial cardiac catheterization on the condition of radial artery grafts for coronary artery bypass grafting (CABG). In this study, we evaluated the influence of transradial catheterization on CABG. We retrospectively evaluated 157 patients who had undergone CABG using the radial artery. The condition of the grafts was assessed intraoperatively. Postoperative coronary angiography was carried out 3 months after the surgical intervention. The patency of the grafts was assessed by 2 cardiologists. One-quarter of the radial artery grafts were affected by transradial catheterization. Since most of them were located only at the puncture site, the graft itself was capable of being used for grafting after the resection of its affected distal end. The patency rate was not affected by transradial catheterization.
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