Skeletonized Radial Artery Grafting: One-Year Patency Rate

Authors

  • Hitoshi Hirose
  • Atsushi Amano

DOI:

https://doi.org/10.1532/HSF98.20041017

Abstract

Background: The skeletonized radial artery harvesting technique has routinely been used in our institute. Its clinical outcome is acceptable; however, the graft patency rate at 1 year has not been reported.

Methods: Between July 1, 2003, and October 31, 2002, 50 consecutive patients underwent isolated coronary artery bypass using skeletonized radial artery grafts in our hospital. There were no hospital deaths or perioperative myocardial infarctions. All patients completed follow-up by November 2003. Twenty of these patients (18 asymptomatic volunteers and 2 symptomatic patients) underwent coronary angiography at 1 year, and the results were analyzed.

Results: At a mean (±SD) follow-up period of 1.2 ± 0.2 years, there were no deaths. Two patients developed angina due to graft occlusion (1 in the radial artery and another in the gastroepiploic artery). Twenty-one radial artery grafts and 36 distal anastomoses with radial artery grafts were evaluated by angiography at 1 year (0.9 ± 0.1 years). There was 1 radial artery graft occlusion affecting 1 distal anastomosis, giving a perfect graft patency rate of 95.2% (20/21) and a perfect anastomosis patency rate of 97.2% (35/36). The patient with the occluded radial artery graft had a history of peripheral vascular disease and diabetes. There were no graft stenoses or string signs.

Conclusion: At our limited follow-up, the results of using skeletonized radial artery grafts are excellent. Extensive skeletonization will not affect the graft patency rate or early graft spasm. Careful examinations of the radial artery grafts in patients with a history of peripheral artery disease and diabetes are mandated.

References

Gaudino M, Trani C, Glieca F, et al. 2003. Early vasoreactive profile of skeletonized versus pedicled internal thoracic artery grafts. J Thorac Cardiovasc Surg 125:638-41.nHigami T, Maruo A, Yamashita T, Shida T, Ogawa K. 2000. Histologic and physiologic evaluation of skeletonized internal thoracic artery harvesting with an ultrasonic scalpel. J Thorac Cardiovasc Surg 120:1142-7.nFitzgibbon GM, Kafka HP, Leach AJ. 1996. Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and re-operation in 1,388 patients during 25 years. J Am Coll Cardiol 28:616-26. Localization of nitric oxide synthase type III in the internal thoracic and radial arteries and the great saphenous vein: a comparative immunohistochemical study. J Thorac Cardiovasc Surg 125:1510-5.nHirose H, Amano A, Takahashi A, Takanashi S. 2003. Skeletonization of radial artery using ultrasonic scalpel, clinical and angiographic results. Heart Surg Forum 6:E42-7.nKamiya H, Ushijima T, Kanamori T, et al. 2003. Use of the radial artery graft after transradial catheterization: is it suitable as a bypass conduit? Ann Thorac Surg 76:1505-9.nKaufer E, Factor SM, Frame R, Brodman RF. 1997. Pathology of the radial and internal thoracic arteries used as coronary artery bypass grafts. Ann Thorac Surg 63:1118-22.nManasse E, Sperti G, Suma H, et al. 1996. Use of the radial artery for myocardial revascularization. Ann Thorac Surg 62:1076-82.nMoran SV, Baeza R, Guarda E, et al. 2001. Predictors of radial artery patency for coronary artery bypass. Ann Thorac Surg 72:1552-6.nOhtsuka T, Wolf RK, Hiratzka LF, Wurnig P, Flege JB Jr. 1997. Thoracoscopic internal mammary artery harvest for MICABG using the Harmonic Scalpel. Ann Thorac Surg 63:S107-9.nParolari A, Rubini P, Alamanni F, et al. 2000. The radial artery: which place in coronary operation? Ann Thorac Surg 69:1288-94.nPsacioglu H, Atay Y, Celindag B, Saribulbul O, Buket S, Hamulu A. 1998. Easy harvesting of radial artery with ultrasonically activated scalpel. Ann Thorac Surg 65:984-5.nReardon MJ, Conklin LD, Reardon PR, Baldwin JC. 1997. Coronary artery bypass conduits: review of current status. J Cardiovasc Surg (Torino) 38:201-9.nRonan JW, Perry LA, Barner HB, Sundt TM III. 2000. Radial artery harvest: comparison of ultrasonic dissection with standard technique. Ann Thorac Surg 69:113-4.nAcar C, Jebara VA, Portoghese M, et al. 1992. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 54:652-9, discussion 659-60.nAmano A, Takahashi A, Takanashi S, Hirose H. 2002. Skeletonized radial artery grafting: improved angiographic results. Ann Thorac Surg 73:1880-7.nBarner HB. 2002. Remodeling of arterial conduits in coronary grafting. Ann Thorac Surg 73:1341-5.nBizzarri F, Frati G. 2002. Harvesting of the radial artery: skeletonization versus pedicled technique. Ann Thorac Surg 73:1359.nBuxton B, Windsor M, Komeda M, Gear J, Fuller J, Liu J. 1997. How good is the radial artery as a bypass graft? Coron Artery Dis 8:225-33.nCalafiore AM, Di Giammarco G, Teodori G, et al. 1995. Radial artery and inferior epigastric artery in composite grafts: improved midterm angiographic results. Ann Thorac Surg 60:517-24.nChoi JB, Lee SY. 1996. Skeletonized and pedicled internal thoracic artery grafts: effect on free flow during bypass. Ann Thorac Surg 61:909-13.nFisk RL, Brooks CH, Callaghan JC, Dvorkin J. 1976. Experience with the radial artery graft for coronary artery bypass. Ann Thorac Surg 21:513-8.nTaggart DP, Mathur MN, Ahmad I. 2001. Skeletonization of the radial artery: advantages over the pedicled technique. Ann Thorac Surg 72:298-9.nUeda T, Taniguchi S, Kawata T, Mizuguchi K, Nakajima M, Yoshioka A. 2003. Does skeletonization compromise the integrity of internal thoracic artery grafts? Ann Thorac Surg 75:1429-33.nvan Son JA, Smedts F, Vincent JG, van Lier HJ, Kubat K. 1990. Comparative anatomic studies of various arterial conduits for myocardial revascularization J Thorac Cardiovasc Surg 99:703-707.n

Published

2005-01-04

How to Cite

Hirose, H., & Amano, A. (2005). Skeletonized Radial Artery Grafting: One-Year Patency Rate. The Heart Surgery Forum, 7(4), E277-E282. https://doi.org/10.1532/HSF98.20041017

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