CLINICAL OUTCOMES IN PATIENTS UNDERGOING CORONARY-ARTERY BYPASS-GRAFTING WITH PREFERRED USE OF THE RADIAL ARTERY

Background: The use of the radial artery (RA) for coronary artery bypa ss grafting (CABG) is still not widely accepted. The purpose of this s tudy was to evaluate the impact of preferred RA utilization on clinica l outcomes. Methods: Data on 138 consecutive patients undergoing CABG using the RA (in addition to the internal mammary artery) were prospec tively collected and compared to 228 patients undergoing CABG without the RA. Results: The mean age was 56 +/- 10 years (range 29 to 79 year s). Preoperatively 91% (126/138) were in CCS angina Class III/IV, 45% (66/138) were nonelective, and 14% (20/138) were reoperations. An aver age of 3.5 +/- 0.9 grafts per patient were performed, of which 2.5 +/- 0.5 (71%) were arterial. The RA was used for single distal vessel in 103 patients, for sequential grafting in 35, and overall for 1.3 dista l targets per patient. There were no perioperative deaths, reoperation for bleeding, MI, or CVA. Six patients (4%) had minor RA harvest-rela ted complications. The length of hospital stay was 5.6 +/- 3.1 days, H ospital outcomes were similar to a cohort of patients undergoing CABG without RA. Mean follow-up for 99% (137/138) of patients was 7.1 +/- 4 .3 months (range 1 to 18 months). Long-term major complications includ ed one sudden death (0.7%) and three Mis (2.2%). At the time of follow -up, 95% (131/137) were in CCS angina Class I/II. Routine thallium str ess test performed in 93 patients showed normal perfusion in 98%. Ther e were no long-term major vascular or neurological deficits related to RA harvest. Conclusions: The use of RA in patients undergoing CABG is safe and effective. These excellent early clinical outcomes justify l iberal use of the RA, although long-term follow-up is required to esta blish its ultimate role as a preferred conduit.