Role of Radial Artery Graft in Coronary Artery Bypass Grafting

• Published in: The Annals of thoracic surgery Vol. 79; no. 6; pp. 2180 - 2188
• Main Authors: Sajja, Lokeswara Rao, Mannam, Gopichand, Pantula, Narasinga Rao, Sompalli, Sriramulu
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2005; Elsevier Science
• Subjects: Anastomosis, Surgical; Biological and medical sciences; Cardiology. Vascular system; Contraindications; Coronary Artery Bypass - methods; Coronary heart disease; Coronary Stenosis - surgery; Forearm - blood supply; Heart; Humans; Medical sciences; Radial Artery - anatomy & histology; Radial Artery - physiology; Radial Artery - surgery; Radial Artery - transplantation; Spasm - etiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the respiratory system; Tissue and Organ Harvesting - methods; 23; Treatment; Coronary artery bypass; Respiratory disease; Cardiovascular disease; Graft; Thorax; Coronary heart disease; Radial artery
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2004.07.049

The use of the radial artery (RA) as a coronary artery bypass graft has assumed a revival and thus a multitude of issues have arisen surrounding the routine and widespread use of this conduit in myocardial revascularization. There has been no uniformity regarding harvest techniques, assessment of the adequacy of hand collateral circulation, antispasm protocols, selection of target vessels, and the site of proximal anastomosis. It is widely believed and practiced that the RA should be harvested as a pedicle graft and preferably be used to bypass critically stenosed (>70% stenosis) coronary arteries. It is used either as a free graft with proximal anastomosis to the ascending aorta or as a composite arterial graft along with the left or right internal thoracic artery. The patency of RA grafts depends on the severity of the target coronary artery stenosis and target artery location rather than its use as an aortocoronary conduit or composite graft. In this article, we reviewed the current knowledge regarding the use of RA grafts as a coronary bypass conduit in an attempt to suggest a few acceptable strategies concerning the above issues in a given clinical scenario.