PATHOLOGY OF THE RADIAL AND INTERNAL THORACIC ARTERIES USED AS CORONARY-ARTERY BYPASS GRAFTS

Background. This investigation compared the incidence and the degree o f atherosclerosis present in radial artery (RA) and internal thoracic artery segments remaining after coronary artery bypass grafting. Metho ds. One hundred seventy specimens from 102 patients were histologicall y analyzed, including 106 RA specimens. Results. The mean degree of pa thology for the RA was 0.89 on a 0 (none) to 4 (lumen completely oblit erated) scale; the mean grade of pathology for the internal thoracic a rtery was 0.30 (p < 0.001). Presence of diabetes, aortofemoral disease , femoral-popliteal disease, age, and male gender correlated with an i ncrease in RA pathology. Flow in the in situ RA did not correlate with the degree of pathology. Conclusions. Study of the excess RA and inte rnal thoracic artery segments remaining after coronary artery bypass g rafting demonstrated that the RA had a higher degree of atherosclerosi s than the internal thoracic artery at the time of harvest. Overall se verity of disease in the RA was low. The long-term performance of RA g rafts will determine whether this level of atherosclerotic disease has any clinical significance. (C) 1997 by The Society of Thoracic Surgeo ns.