The Radial Artery for Coronary Artery Bypass Grafting: Clinical and Angiographic Results at Five Years

J Thorac Cardiovasc Surg. 1998 Dec;116(6):981-9. doi: 10.1016/S0022-5223(98)70050-9.

Abstract

Objective: The aim of this study was to assess the long-term results of use of the radial artery as a conduit for coronary artery bypass grafting.

Methods: After revival of the technique in 1989, the radial artery was used as a conduit in 910 patients undergoing coronary artery bypass grafting. A complete follow-up was obtained for the first 102 consecutive patients from 4 to 7 years after the operation (mean 5.27 +/- 1.30 years). Fifty-nine percent of the patients were receiving calcium-channel inhibitors. An electrocardiographic stress test was obtained for 51 patients, with no contraindications found. Routine follow-up angiography was performed in 50 cases, including those of all patients with symptoms. Thus 64 radial artery and 48 left internal thoracic artery grafts were followed up from 4 to 7 years after the operation (mean 5.6 +/- 1.40 years).

Results: The actuarial survival was 91.6% at 5 years, and the actuarial rate of freedom from angina was 88.7% at 5 years. Four patients underwent percutaneous transluminal angioplasty during the period of follow-up, and there were no reoperations for revision of the bypass. The electrocardiographic stress test showed negative results in 73% of cases, electrocardiographic changes alone in 21%, and clinically positive results in 6%. Angiography showed that the patency rate of the radial artery grafts was 83%. The patency rate of the left internal thoracic artery grafts (n = 47) was 91%. The difference in patency could be related to the implantation sites of the grafts, mainly the circumflex artery (51%) for the radial artery grafts and almost exclusively the left anterior descending artery (94%) for the left internal thoracic artery.

Conclusion: The use of the radial artery for coronary bypass grafting provides excellent clinical and angiographic results at 5 years. Routine use of the radial artery in combination with the left internal thoracic artery can be recommended.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use
  • Coronary Angiography*
  • Coronary Artery Bypass* / methods
  • Coronary Artery Bypass* / mortality
  • Coronary Disease / mortality
  • Coronary Disease / surgery*
  • Electrocardiography
  • Follow-Up Studies
  • Humans
  • Mammary Arteries / transplantation
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Postoperative Complications / mortality
  • Postoperative Complications / prevention & control
  • Radial Artery / transplantation*
  • Recurrence
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors