Skeletonization of the Radial Artery with the Ultrasonic Scalpel: Clinical and Angiographic Results
Background: To improve the patency rate of the radial artery graft, we have been using a skeletonized harvesting technique since September 1, 2001. Our early reports confirmed better graft patency of the skeletonized radial graft than the conventional pedicled graft. However, its midterm results were unknown. We present our recent experience and follow-up results of radial artery grafting using the skeletonized harvesting technique.
Methods: Between September 1, 2001, and July 31, 2002, 391 patients underwent isolated coronary artery bypass surgery in our hospital group, excluding minimally invasive direct coronary bypass procedures via small thoracotomy or T-grafting. Among them, skeletonized radial grafting was performed in 246 patients (182 men and 64 women; mean age, 66.2 ± 9.5 years). Follow-up is to be completed by December 31, 2003. Perioperative, early angiographic, and follow-up results were analyzed.
Results: There were 1 hospital death and 5 incidences of postoperative myocardial infarction. None of these occurrences were related to radial artery bypass. Early angiography revealed that the stenosis-free graft patency rate of radial artery anastomoses (291/303 cases, 96.0%) was not significantly different from the patency rates of surgeries involving the use of other conduits (left internal mammary artery, 95.1%; right internal mammary artery, 93.8%; gastroepiploic artery, 93.1%; and saphenous vein, 98.2%). Follow-up was completed for all hospital survivors with a mean follow-up time of 1.4 ± 0.3 years. There were no cardiac deaths and 5 cardiac events, giving a cardiac event-free rate of 97.5%. Conclusion: In our limited follow-up, cardiac events have been well controlled. Midterm follow-up angiographic study is necessary to confirm our clinical outcome data.
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