Myocardial revascularization with the radial artery: a clinical and angiographic study.
BACKGROUND
It has been well documented that the use of the internal thoracic artery yields better long-term patency rates than saphenous vein grafts for coronary artery bypass grafting. This knowledge has prompted surgeons to use other arterial conduits such as the radial artery.


METHODS
Between April 1994 and January 1996, radial artery grafts were used in 83 patients (mean age, 54.6 years) undergoing myocardial revascularization. All patients received diltiazem, 80 mg orally three times daily. Angiographic studies were performed in the early post-operative period in 61 patients, and 6 to 19 months later in 12 patients.


RESULTS
There were four hospital deaths (4.8%), none of them due to cardiac causes. Perioperative myocardial infarction was observed in 3 patients, 1 related to a radial artery graft occlusion. Of 61 grafts studied early, 59 were patent (96.7%), but two grafts showed diffuse spasm. Twelve patients had a second angiogram after a mean interval of 8.7 months, and all grafts were patent. One patient who had a diffuse spasm at the early study had recurrent symptoms, and repeat angiogram showed further narrowing of the graft (string sign).


CONCLUSIONS
Our results suggest that with proper care, the radial artery may be used for coronary artery bypass grafting with good early results. Long-term follow-up and angiography studies will be needed to establish the merit of the radial artery as a graft for coronary artery operations.
da Costa
F D
FD
Department of Cardiac Surgery of the Santa Casa, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil.
da Costa
I A
IA
Poffo
R
R
Abuchaim
D
D
Gaspar
R
R
Garcia
L
L
Faraco
D L
DL
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003329:Coronary Vasospasm / Q000209:etiology; D004110:Diltiazem / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D017534:Radial Artery / Q000503:physiopathology / Q000637:transplantation*; D012008:Recurrence; D015996:Survival Rate; D014654:Vascular Patency; D014661:Vasoconstriction; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use
D002317:Cardiovascular Agents; D014665:Vasodilator Agents; D004110:Diltiazem