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Assessment of Radial Artery Graft Patency in Symptomatic Patients
Ertekin U Unal1, Ferit Cicekcioglu1, Anil Ozen1
1Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
Insights
Radial artery (RA) graft patency is influenced by target vessel characteristics. RA grafts to the right coronary system or less than 90% stenosed arteries have a higher failure risk.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Coronary Artery Bypass Grafting
Background:
- Radial artery grafts are utilized in coronary artery bypass grafting.
- Evaluating graft patency is crucial for long-term patient outcomes.
Purpose of the Study:
- To assess the patency of radial artery grafts.
- To identify factors influencing radial artery graft patency in coronary artery bypass grafting.
Main Methods:
- Kaplan-Meier analysis was used to determine 5-year graft patency.
- Cox proportional hazard models assessed relationships between graft patency and stenosis degree, target vessel location, and inflow characteristics.
- Coronary angiography was performed on 83 symptomatic patients or those with positive ischemic tests following coronary artery bypass grafting.
Main Results:
- Radial artery graft patency was significantly higher for the left coronary system (85.5%) compared to the right (65.4%).
- Grafts to target vessels with proximal stenosis ≥90% showed higher patency rates (OR, 3.65).
- Overall 5-year radial artery graft patency was 79.2%.
Conclusions:
- Radial artery graft patency is dependent on the degree of native coronary artery stenosis and target vessel location.
- Grafts to non-severely stenosed coronary systems (<90%) and the right coronary territory are associated with a high risk of graft failure.
Background:
The purpose of this study is to evaluate the patency of radial artery (RA) grafts consistent with the target vessel characteristics.
Methods:
Between October 2001 and January 2012, 83 symptomatic patients or patients with positive ischemic test results underwent coronary angiography following coronary artery bypass grafting. Of these, 68 patients with 81 RA grafts at a mean 49.2 ± 31.9 months (range, 1-137 months) were evaluated. According to the location and degree of proximal stenosis, 5-year graft patency was determined by Kaplan-Meier analysis. The relationships between RA graft patency and degree of proximal stenosis, target vessel location, and inflow characteristics of grafts were assessed by means of Cox proportional hazard models.
Results:
Mean age of the patients was 56.4 ± 10.2 years. The period between the operation and postoperative coronary angiography was 49.2 ± 31.9 months (range, 1-137 months; median, 48.8 months). There was no impact on RA patency with regard to preoperative characteristics of the patients. RA patency was higher for left coronary system compared with right system (p = 0.038; 85.5 vs. 65.4%). In addition, patency rate was statistically higher for the proximal stenosis ≥ 90% (odds ratio, 3.65; 95% confidence interval, 1.20-11.07; p = 0.018). Kaplan-Meier patency analysis showed a patency of RA as 79.2% at 5 years.
Conclusion:
RA graft patency differs with degree of preoperative native coronary artery stenosis and location of target vessel. RA grafts to not severely stenosed (< 90%) coronary system and to the right coronary territory carry a remarkably high risk of graft failure.
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