THE RADIAL ARTERY AS A BYPASS GRAFT

The radial artery is being reintroduced into clinical practice to incr ease the number of arterial grafts for patients undergoing coronary ar tery bypass surgery. The radial artery is readily available from one o r both forearms and removal is safe in patients who have a normal coll ateral circulation to the hand. Harvesting the radial artery with the adjacent veins using a minimal touch technique and vasodilators will p revent vasospasm and possibly early occlusion. A concern is that subcl inical atheroma is present in many patients. The radial artery can be used as a single graft, anastomosed in a ''Y'' fashion with the intern al mammary artery, or used as a sequential graft. The early mortality and complications are low. There are potential cost savings because th e need for an incision in the leg is avoided, so that patients may be discharged early. The early results of radial artery grafting are enco uraging. Further follow-up is required to determine the late patency a nd effects on survival of using the radial artery graft.