Radial Artery Free and T Graft Patency as Coronary Artery Bypass Conduit Over a 15-Year Period

• Published in: Circulation (New York, N.Y.) N.Y.), 2012-09, Vol.126 (11), p.S140-S144
• Main Authors: BARNER, Hendrick B, BAILEY, Marci, GUTHRIE, Tracey J, PASQUE, Michael K, MOON, Marc R, DAMIANO, Ralph J, LAWTON, Jennifer S
• Format: Article
• Language: English
• Subjects: Aged; Anastomosis, Surgical - methods; Aorta, Thoracic - surgery; Biological and medical sciences; Blood and lymphatic vessels; Cardiac Catheterization; Cardiology. Vascular system; Coronary Artery Bypass - methods; Coronary Artery Bypass - statistics & numerical data; Coronary Disease - surgery; Coronary Restenosis - epidemiology; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; Graft Survival; Humans; Kaplan-Meier Estimate; Male; Mammary Arteries - surgery; Medical sciences; Middle Aged; Postoperative Complications - mortality; Radial Artery - surgery; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Treatment Outcome; Vascular Patency
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.111.081497

The radial artery is often used as the second arterial graft for coronary artery bypass grafting. Little is known about the differences in long-term patency between radial free and T grafts. This study was performed to determine long-term radial artery patency over a 15-year period. Radial arteries were used as free grafts or T grafts for coronary artery bypass grafting over a 15-year period. Patients were contacted to determine if postoperative cardiac catheterization was performed and examination of any reports and films was performed. Grafts were graded as patent, luminal irregularity, or occluded. Each sequential graft was counted separately. Between September 1993 and December 2008, 13,926 patients underwent isolated coronary artery bypass grafting and 3248 patients had at least one radial artery graft used as a conduit. Catheterizations were performed at a mean of 7.4 ± 3.8 years (range, 3 days to 14.4 years) on 372 radial artery grafts (103 free and 269 T) in 215 patients. Kaplan-Meier freedom from occlusion for radial free and T grafts at 1 and 10 years was 97.1% and 75.4% and 99.6% and 62.9%, respectively (P=0.146 free versus T). Kaplan-Meier survival to 15 years was not statistically different between free and T graft patients (P=0.5). In 215 patients with postoperative catheterization after coronary artery bypass grafting with a radial artery graft, radial free and T grafts had similar and acceptable long-term patency to support their use as a coronary artery bypass graft conduit.