Chronic compensatory increase in ulnar flow and accelerated atherosclerosis after radial artery removal for coronary artery bypass.
BACKGROUND
Only scant information is available on the chronic consequences of radial artery removal for coronary artery bypass surgery on forearm circulation.


METHODS
Twenty-five patients submitted to radial artery removal for coronary artery bypass were submitted to serial Doppler echocardiographic evaluation of the flow and morphology of the forearm arteries.


RESULTS
The peak systolic velocity of the ulnar artery of the operated side was significantly higher than that of the control site. The intimal-medial thickness of the ulnar artery was always significantly higher on the operated side, and this difference reached statistical significance at 10 years' follow-up. There was a significantly higher prevalence of atherosclerotic plaques in the ulnar artery of the operated versus control arm (7/25 vs 0/25, P = .03).


CONCLUSIONS
Radial artery removal for coronary artery bypass surgery leads to a chronic increase in ulnar flow accompanied by increased intimal-medial thickness and accelerated atherosclerotic disease. These findings might have potentially important implications for surgical indications and patient management.
Departments of Cardiac Surgery and Angiology, Catholic University, Largo A. Gemelli 8, 00168 Rome, Italy. m.gaudino@tiscali.it
Mario
M
Gaudino
Michele
M
Serricchio
Paolo
P
Tondi
Laura
L
Gerardino
Angela
A
Di Giorgio
Paolo
P
Pola
Gianfederico
G
Possati
D001161:Arteriosclerosis / Q000503:physiopathology*; D001916:Brachial Artery / Q000503:physiopathology; D001026:Coronary Artery Bypass / Q000379:methods*; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000637:transplantation*; D012039:Regional Blood Flow; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D014664:Vasodilation / Q000502:physiology*