Radial Artery Conduit Use After Transradial Catheterisation

Transradial catheterisation (TRC) via the radial artery (RA) is now the default approach for coronary angiography, but TRC is known to be associated with endothelial damage and vasodilatory dysfunction of the RA. To date, there is insufficient evidence regarding the impact of TRC on RA graft patency.

This retrospective cohort study of patients who underwent coronary artery bypass grafting with previously catheterised RA grafts was conducted at two major hospitals in Victoria, Australia. Graft patency was assessed with either invasive or computed tomography coronary angiography.

Overall, 68 patients were studied, all of whom had bilateral RAs harvested, of which all right RAs had been previously catheterised for angiography. Grafts included sequential and Y grafts leading to 90 left RA (LRA) grafts and 76 right RA (RRA) grafts studied. Previously catheterised RRA grafts had significantly lower patency (72%) than non-catheterised LRA grafts (87%; p=0.02). Female sex, peripheral vascular disease, and a history of myocardial infarction were associated with RRA graft occlusion. Severe right coronary artery stenosis was associated with RRA graft patency.

Previously catheterised RRA grafts may have a lower patency rate than non-catheterised LRA grafts. However, previously catheterised RAs remain a useful conduit option especially when other conduit choices are limited.