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CABG long-term patency rate for radial artery not inferior to internal thoracic artery
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The 20-year patency rate for radial artery grafts used as a conduit in CABG is comparable to use of the left internal thoracic artery, according to a study published in the Journal of the American College of Cardiology.
Mario Gaudino, MD, from the department of cardiovascular sciences at the Catholic University in Rome, and colleagues analyzed data from 100 patients receiving a radial artery graft and were followed up at a 100% rate for 2 decades.
A report from the Society of Thoracic Surgeons’ Adult Cardiac Surgery Database documented that radial artery was employed in less than 6% of all primary CABG procedures in the United States from 2000 to 2009.
During follow-up, there were 64 deaths, 23 (35.9%) from CV causes. Thirty-three of the 36 survivors underwent postsurgical radial artery graft control at a mean of 19 years after surgery. The 20-year patency rate was 84.8%.
In the overall population, graft-failure probability at the 20-year mark was 19% for the left internal thoracic artery, 25% for radial artery and 55% for the saphenous vein (P = .002 for radial artery vs. saphenous vein; P = .11 for radial artery vs. internal thoracic artery, and P < .001 for internal thoracic artery vs. saphenous vein).
During the trial, 25 patients were evaluated for forearm circulation at a mean interval of 17.6 years after surgery using Doppler echocardiography. The forearm operated on yielded an increase regarding the diameter of the ulnar artery (2.44 mm vs. 2.01 mm; P < .05). The operated-upon arms had similar flow parameters compared with control arms.
Target vessel stenosis of more than 90% predicted loss of long-term patency, but location of distal anastomosis did not, Gaudino and colleagues wrote.
“The 20-year patency rate of [radial artery] grafts is good, and not inferior to the [internal thoracic artery], especially when the conduit is used to graft a vessel with > 90% stenosis,” the researchers wrote. “[Radial artery] harvesting does not lead to hand or forearm symptoms, even at a very long-term follow-up.” – by James Clark
Disclosure: The researchers report no relevant financial disclosures.
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