title: Effects of skeletonized versus pedicled radial artery on postoperative graft patency and flow.
abstract: BACKGROUND
  Radial artery (RA) was the second arterial graft introduced in clinical practice for myocardial revascularization. The skeletonization technique of the left internal thoracic artery (LITA) may actually change the graft's flow capacity with potential advantages. This leads to the assumption that the behavior of the RA, as a coronary graft, is similar to that of the LITA, when skeletonized.
  
  
  OBJECTIVE
  This study evaluated 'free' aortic-coronary radial artery (RA) grafts, whether skeletonized or with adjacent tissues.
  
  
  METHODS
  A prospective randomized study comparing 40 patients distributed into two groups was conducted. In group I, we used skeletonized radial arteries (20 patients), and in group II, we used radial arteries with adjacent tissues (20 patients). After the surgical procedure, patients underwent flow velocity measurements.
  
  
  RESULTS
  The main surgical variables were: RA internal diameter, RA length, and free blood flow in the radial artery. The mean RA graft diameters as calculated using quantitative angiography in the immediate postoperative period were similar, as well as the flow velocity measurement variables. On the other hand, coronary cineangiography showed the presence of occlusion in one RA graft and stenosis in five RA grafts in GII, while GI presented stenosis in only one RA graft (p = 0.045).
  
  
  CONCLUSIONS
  These results show that the morphological and pathological features, as well as the hemodynamic performance of the free radial artery grafts, whether prepared in a skeletonized manner or with adjacent tissues, are similar. However, a larger number of non-obstructive lesions may be observed when RA is prepared with adjacent tissues.
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Rômulo C Arnal
authors.initials: RC
authors.lastname: Bonini
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Staico
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Mario
authors.initials: M
authors.lastname: Issa
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Antoninho Sanfins
authors.initials: AS
authors.lastname: Arnoni
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Chaccur
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Camilo
authors.initials: C
authors.lastname: Abdulmassih Neto
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Jarbas Jackson
authors.initials: JJ
authors.lastname: Dinkhuysen
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Paulo Paredes
authors.initials: PP
authors.lastname: Paulista
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Luiz Carlos Bento de
authors.initials: LC
authors.lastname: Souza
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Luiz Felipe P
authors.initials: LF
authors.lastname: Moreira
mesh_terms: D060050:Angina, Stable / Q000601:surgery; D000789:Angina, Unstable / Q000601:surgery; D001783:Blood Flow Velocity; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D011184:Postoperative Period; D011446:Prospective Studies; D017534:Radial Artery / Q000503:physiopathology / Q000637:transplantation*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014654:Vascular Patency