Radial artery bypass graft is a feasible and durable conduit for challenging infrainguinal revascularization: 17 years of Melbourne experience.
OBJECTIVE
The superiority of autogenous venous conduits in infrainguinal bypass surgery is well established. In the absence of suitable leg or arm veins the radial artery can be utilized as an alternative autogenous conduit. In contrast to cardiac surgery, experience with the radial artery as a conduit for infrainguinal bypass surgery is limited. The purpose of this study was to review the outcomes of our radial artery bypasses over the last 17 years.


METHODS
All radial artery bypasses performed between 1995 and 2012 were identified from a prospective database. Patency, limb salvage, and survival were calculated using the Kaplan-Meier survival estimate method.


RESULTS
Twenty-nine radial artery bypasses were performed in 28 patients. Median follow-up was 55 months (range 1-170). Twelve-month primary, assisted primary, and secondary patency rates were 49%, 62%, and 73% respectively; Both 3-year and 5-year primary, assisted primary, and secondary patency rates were 49%, 56% and 67% respectively. Limb salvage rate was 75% at 1- and 5-year follow-up. Patient survival at 1, 3, and 5 years was 96%, 88%, and 76%.


CONCLUSIONS
For patients with need of challenging infrainguinal revascularization without suitable autogenous venous conduit, a radial artery bypass can be performed safely with favorable long-term patency and limb salvage rates.
Department of Vascular Surgery, Austin Health, Melbourne, Australia. Electronic address: bmemees@hotmail.com.
B M E
BM
Mees
Department of Vascular Surgery, Austin Health, Melbourne, Australia.
D R
DR
Robinson
Department of Vascular Surgery, Austin Health, Melbourne, Australia.
G
G
Fell
Department of Vascular Surgery, Austin Health, Melbourne, Australia.
A T W
AT
Chan
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D064592:Autografts; D005240:Feasibility Studies; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D017131:Thrombectomy; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000401:mortality; D014654:Vascular Patency; D014739:Victoria
Infrainguinal bypass; Peripheral vascular disease; Radial artery