RADIAL GRAFT FOR CORONARY REVASCULARIZATION - TECHNICAL CONSIDERATIONS

Background. Use of the radial artery for coronary artery bypass grafti ng is controversial. Methods. Between November 1999 and December 1994, the radial artery artery graft was used in 165 patients (mean age, 63 .7 years) undergoing coronary revascularization. To prevent spasm, the radial artery was not skeletonized, and calcium-channel blockers were administered routinely. Results. No ischemic or functional complicati ons occurred in the hand after harvesting of the radial artery. Only 1 patient (0.6%) sustained a perioperative myocardial infarction in an area revascularized with a radial artery. The overall mortality was 3. 0% (5 patients), but no deaths were caused by failure of the radial ar tery graft. During a mean follow-up of 14.0 months, angina recurred in 5 patients (3.0%), all of whom had widely patent radial artery grafts on angiography. Radionuclide exercise studies were performed 1 year a fter operation in 84 patients, 2 of whom (2.4%) had stress-induced def ects in areas grafted with a radial artery. Conclusions. Perioperative myocardial infarction, mortality, and recurrent angina usually were n ot related to failure of the radial artery graft. Our results suggest that the radial artery is an excellent alternative conduit for myocard ial revascularization and may be used safety, especially in patients w ith poor-quality or unavailable saphenous veins.