To reverse or not to reverse the radial artery in coronary artery bypass graft surgery? Histopathologic concerns and media thickness

• Published in: Heliyon 2023-10, Vol.9 (10), p.e20873-e20873, Article e20873
• Main Authors: Mir Mohammad Sadeghi, Pouya, Mir Mohammad Sadeghi, Mohsen, Derakhshan, Maryam, Mir Mohammad Sadeghi, Amir, kazemian, Amir Hossein, Abbasivand, Ali
• Format: Article
• Language: English
• Subjects: Coronary artery bypass; Radial artery; Tunica intima; Tunica media; Vasoconstriction
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2023.e20873

Radial artery (RA) is a popular coronary artery bypass grafting (CABG) conduit. The challenging issue is vasospasm. A few studies are available on histopathological differences between RA's proximal and distal ends. This study aims to compare histopathological features of the proximal and distal end of RA to find the best technique for anastomosis. In this matched case-control study, 80 patients were included who underwent CABG and used RA as a graft. Ten subjects were excluded. RA was harvested by open technique, and a cocktail of Papaverine, Verapamil, and Nitroglycerine was frequently applied topically. One centimeter of proximal and distal ends of the RA was evaluated considering its Histopathology. Clinical signs of RA graft vasospasm were monitored from harvesting until the post-operative period. Intima, media, and intima-media thickness (IMT) index were compared between the two cohorts. Vasospasm occurred in 1.41% of patients. The mean intimal thickness in the proximal and distal ends were, respectively, 0.20 (standard deviation [SD] 0.17 mm) vs. 0.31 (SD 0.18 mm) (p