CABG Using Radial Artery Grafts Associated With Improved Patient Outcomes

Routine use of radial artery grafts for coronary artery bypass surgery does not increase morbidity or mortality, or unduly complicate the procedure, according to a report by UK researchers.

Dr. Mohamed Amrani and colleagues, from Harefield Hospital, Middlesex, note in the February issue of the Annals of Thoracic Surgery that uptake of radial artery CABG by surgeons has been low, but their concerns may be unwarranted.

To evaluate outcomes, the researchers collected data on 151 patients who received radial grafts and compared them with 179 patients who underwent conventional surgery using saphenous vein grafts. In both patient groups, median cardiopulmonary bypass and cross-clamp times were similar, according to the group’s report.

Furthermore, mortality, stroke and sternal infection occurred in each instance in 1% of the radial graft patients and in 2% of the saphenous graft patients, the researchers report.

They also assessed subjective outcomes in 127 radial graft patients via telephone interviews. Among these patients, 32% experienced paresthesia and 51% reported numbness “related to radial harvest.” However, 75% of these patients also reported that their symptoms had resolved or were resolving.

“Although long-term definitive data on this conduit are required, concerns about increased complexity or morbidity alone should not prevent the adoption of routine radial artery grafting,” Dr. Amrani and colleagues conclude.

“As more than 50% of aortocoronary vein grafts will occlude within 10 years, it is appropriate to explore the use of the radial artery as the potential conduit of choice, after the internal thoracic arteries,” Dr. James Tatoulis, from the University of Melbourne, Australia, writes in a journal commentary. “This [study] further documents the safety and potential benefits of this strategy.”

Ann Thorac Surg 2001;71:555-560.