Radial Artery as a Coronary Artery Bypass Conduit

Gaudino, Mario; Tondi, Paolo; Benedetto, Umberto; Milazzo, Valentina; Flore, Roberto; Glieca, Franco; Ponziani, Francesca Romana; Luciani, Nicola; Girardi, Leonard N.; Crea, Filippo; Massetti, Massimo

doi:10.1016/j.jacc.2016.05.062

Cited by 86 publications

(52 citation statements)

References 13 publications

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“…In framework of potential limb ischemic events, according to Gaudino, twenty-five patients underwent echo Doppler evaluation of the forearm circulation at a mean interval of 17.6±2.1 years from surgery and in the operated forearm, there was a significant increase in the diameter of the ulnar artery (2.44±0.43 mm vs. 2.01±0.47 mm; p<0.05). All other flow parameters were similar between the operated and control arms [9]. Although, this conduit is underused, despite numerous observational studies, which documented excellent RA patency of 89% at 10 years, and 86% at 20 years [10], which still constitute the first choice during the graft selection process.…”

mentioning

confidence: 73%

Total arterial revascularization in patients with multi–vessel coronary artery disease: modern insight on conduit selection

Стуков

Руденко

et al. 2018

ujcvs

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Coronary artery bypass grafting (CABG) remains the most common operation performed by cardiac surgeons today. Fundamental basis of CABG is to reestablish perfusion to the myocardium, however there are different approaches in accomplishing this goal. The collection of scientific publications suggest the use of multiple arterial conduits in patients of young age, preferable without advanced comorbidity and low body surface area. Despite common use of saphenous vein grafts, lots publications demonstrate advantages of arterial conduits. Internal mammary artery (IMA) has patency rates in the region of 90–95% ten to fifteen years after CABG. Based on superior long-term results of the internal mammary artery (IMA), other arteries is being used in CABG. Radial artery (RA) nowadays it is the most popular arterial graft after the IMA in both low- and high-risk patients. Although, this conduit is underused, despite numerous observational studies, which documented excellent RA patency of 89% at 10 years. Furthermore RA and ITA grafting shows a strong protective effect against native coronary artery disease progression in symptomatic patients after CABG. The constellation of recent data and 2018 guidelines of European Society of Cardiology and European Association for Cardiothoracic Surgeons on myocardial revascularization suggest performing total arterial revascularization in patients with multi-vessel coronary artery disease. Purpose. Literature review on recent data in surgical revascularization using multiple arterial grafts in patients with multi-vessel coronary artery disease. Conclusions. Total arterial revascularization is safe and effective method in treatment of multi-vessel coronary artery disease. There is undoubted benefit of total arterial revascularization in short-, mid- and long–term results in frames of angina recurrence, major adverse cardiac events and redo surgery, associated with graft failure, compared to saphenous vein grafts. Total arterial revascularization may have protective effect on native coronary artery from disease progression, along with excellent patency rates in patients after CABG. However, clinical choice of grafts should be based on patient’s general condition, coronary artery anatomy and severity of stenosis.

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mentioning

confidence: 73%

Total arterial revascularization in patients with multi–vessel coronary artery disease: modern insight on conduit selection

Стуков

Руденко

et al. 2018

ujcvs

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“…In addition, there is an accumulating and strong body of literature showing better RA graft patency compared with SV graft patency, including Gaudino and colleagues' recent report [5] of 20-year angiographic data showing equivalent RA and left internal thoracic artery patency, which were both far superior to SV patency. Nonetheless, SV grafting still has a role in coronary artery bypass grafting (CABG).…”

Section: Persistent Inadequate Interpretation Of Data From Previouslymentioning

confidence: 99%

“…From our point of view, there is not an ideal moment to do it. Some researchers think that PPM should be detected 6 to 12 months after surgery, because this variable determines long-term impact on survival [5]. However, taking into account that the patient…”

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confidence: 99%

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Tranbaugh

Schwann

2018

The Annals of Thoracic Surgery

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“…In other studies [24,25] patency rates were reported, but follow-up period was short. For the open technique more data are available in the literature [26,27]. Excellent patency rates have been reported after a long follow-up periods [26][27][28].…”

Section: Arm Swelling and General Health Statementioning

confidence: 99%

“…For the open technique more data are available in the literature [26,27]. Excellent patency rates have been reported after a long follow-up periods [26][27][28]. Since the long term results, so far, are at least equal (if not superior) and complication rates, as well as esthetic result is (at least in our study) very good after using open RA harvesting technique, we believe that it should be equally appreciated and not put aside as the less desirable technique.…”

Section: Arm Swelling and General Health Statementioning

confidence: 99%

Postoperative Complications and Patient’s Satisfaction after Harvesting of the Radial Artery for Coronary Artery Bypass

Milutinovic¹,

Perić²,

Ćirković³

et al. 2018

JPP

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Objectives: There is a paucity of data regarding wound-site complications and patient's satisfaction after harvesting of a radial artery. This study is conducted to evaluate the frequency complications and the level of patient's satisfaction after myocardial revascularization in our setting. Methods: From April 2009 to October 2013, 97 patients had radial artery (RA) used as a graft in myocardial revascularization. The graft was harvested using open technique. This was retrospective study. Telephone questionnaire was used to evaluate: arm pain, swelling, mobility, sensory changes, patient's contentment with a cosmetic result and the general health state. Results: Pain of limited duration was reported by 24 patients (24.7%), none of them reported permanent pain. Some problems in performing everyday's activities were reported by 8 pts (8.2%). Sensory changes were permanently present in 5 pts (5.2%), and frequent arm fatigue was reported by 4 pts (4.1%). Positive opinion regarding the cosmetic result was reported by 95 pts (97.9%). State of the health after surgery, 81 pts (83.5%) described as excellent or good. Patients who had more mobility problems, also had more sensory and neurological discomfort respectively. Patients with better self-reported general health state were also more satisfied with the esthetic effect of the intervention. Conclusions: Using the open technique resulted in excellent cosmetic effect. This gives us credit to point out that exclusive need of the endoscopic as a supreme method might be under the question mark. Our study suggests that individual attitude of the particular patient plays extremely important role in his/her overall satisfaction with the end effect of the procedure.

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Radial Artery as a Coronary Artery Bypass Conduit

Abstract: The 20-year patency rate of RA grafts is good, and not inferior to the ITA, especially when the conduit is used to graft a vessel with >90% stenosis. RA harvesting does not lead to hand or forearm symptoms, even at a very-long-term follow-up.

Cited by 86 publications

References 13 publications

Total arterial revascularization in patients with multi–vessel coronary artery disease: modern insight on conduit selection

Total arterial revascularization in patients with multi–vessel coronary artery disease: modern insight on conduit selection

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Postoperative Complications and Patient’s Satisfaction after Harvesting of the Radial Artery for Coronary Artery Bypass

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