Radial artery for myocardial revascularization: long-term clinical and angiographic results

Background. To evaluate the long-term clinical and angiographic results of the radial artery (RA) as a graft in coronary artery bypass surgery. Methods. One hundred sixty-four patients had a RA graft from July 1992 to July 1994. In 128 (group A) the RA was connected end to side (115) or end to end (13) to the left internal mammary artery. In 36 (group B) the proximal anastomosis was on the ascending aorta. Results. Early mortality was 1.8% (group A 1.6% and group B 2.8%). Eight-year survival was 83.2% ± 3.2% (group A 82.1% ± 3.8% and group B 86.7% ± 6.2%, p = not significant [NS]), and event free survival was 80.1% ± 3.5% (group A 79.9% ± 4.4% and group B 80.2% ± 7.3%, p = NS). Sixty-one patients (37.2%) had an early angiography within 90 days from the operation. Patency rate of RA distal anastomoses were 98.9% (88 of 89), 98.7% in group A (77 of 78), 100% in group B (11 of 11; p = NS). After a mean of 48 ± 27 months (6 to 96), 72 patients (51.1% of the survivors) had a new angiography. Patency rate of RA distal anastomoses was 95.6% (87 of 91), 93.8% in group A (61 of 65) and 100% in group B (26 of 26; p = NS). All the intermediate RA-LIMA anastomoses were patent at the early and late control. Patency rate for RA and IMAs was similar both early (88 of 89 versus 82 of 82; p = NS) and after 48 ± 27 months (87 of 91 versus 93 of 93; p = NS). Conclusions. Long-term clinical results after RA grafting are satisfying. Angiographic patency rate, both early and after 48 months, is higher than 90% and is similar to that obtained with internal mammary arteries. The site of the proximal anastomosis does not influence early and late patency.