Radial artery for myocardial revascularization: long-term clinical and angiographic results

Radial Artery Bypass Grafts Have an Increased Occurrence of Angiographically Severe Stenosis and Occlusion Compared With Left Internal Mammary Arteries and Saphenous Vein Grafts

“…15 Superficially, these reports contradict the present findings; however, these and other long-term angiographic studies largely consisted of patients without symptoms or evidence of myocardial ischemia. 11,12,14,15 Among the 14 symptomatic patients in the first study and 15 patients in the second study, the patency rates were considerably lower: 64% and 73%, respectively. In addition, a recent larger study of 109 patients who underwent cardiac catheterization for symptoms of ischemia showed an overall patency rate of the radial artery graft of only 75.1% at a mean follow-up of 2.3 years.…”

“…Multiple studies have replicated these findings, which indicates that early angiographic patency with radial artery grafts in the modern era consistently exceeds 90% and is similar to results achieved with the IMA. [7][8][9][10][11][12][13] In addition to these reports, the increasing acceptance of the radial artery has been based on 2 studies with angiographic results, both with 5 years of follow-up. In one, angiography in 50 patients with 64 radial grafts revealed a patency rate of 83%.…”

“…In fact, previous studies with the radial artery graft stipulated target-artery conditions to maintain a high level of blood flow. 11 In situations in which this does not occur (less than critical native coronary stenosis or right coronary artery), the radial artery may be more prone to graft occlusion. 13,15,20 The present study does support this mechanism in part, because the patency rate was much lower with anastomoses to non-left anterior descending artery Variables analyzed included type of graft (LIMA, RIMA, SVG, and radial artery) for the entire cohort only and time since CABG, graft target vessel (left anterior descending artery, left circumflex, or right coronary artery), redo CABG, smoking, diabetes mellitus, hypertension, hyperlipidemia, age, and gender for both the entire cohort and the radial artery cohort alone.…”

“…7 Multiple institutions have documented that the radial artery can be used with acceptable morbidity and mortality 8 -10 and that early angiographic results in the modern era approach those of the IMA. [7][8][9][10][11][12][13] This has led to a dramatic increase in the number of patients receiving radial artery bypass grafts. Yet, there are limited data on the later angiographic outcomes of these grafts.…”

Revascularização miocárdica com artéria radial: influência da anastomose proximal na oclusão a médio e longo prazo

“…In these studies, there is no evidence that the proximal anastomosis affects RA patency at mid-term [24]. Currently, the site of proximal anastomosis is recommended, considering, for example, the less or even no manipulation of the ascending aorta [21].…”