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Eur J Cardiothorac Surg 2006;30:341-346
© 2006 Elsevier Science NL

Review

The fate of the radial artery conduit in coronary artery bypass grafting surgery

Duko G. Nei^_*, Aleksandar M. Kneevi, Predrag S. Milojevi, Boko P. ukanovi, Miomir . Jovi, Milorad D. Borzanovi, Aleksandar N. Nekovi

Dedinje Cardiovascular Institute, M. Tepia 1, 11040 Belgrade, Serbia and Montenegro

Received 23 March 2006; received in revised form 27 April 2006; accepted 15 May 2006.

^_* Corresponding author. Address: Department of Cardiac Surgery, Dedinje Cardiovascular Institute, M. Tepia 1, 11040 Belgrade, Serbia and Montenegro. Tel.: +381 11 3601647/9/724; fax: +381 11 2666392. (Email: nezic{at}EUnet.yu).

Coronary artery bypass grafting (CABG) is the standard surgical procedure for the treatment of advanced coronary artery disease. CABG surgery has been demonstrated to improve symptoms and, in specific subgroups of patients, to prolong life. Despite its success, the long-term outcome of coronary bypass surgery is strongly influenced by the fate of the vascular conduits used. Impressive long-term disease-free patency rate of the left internal thoracic artery–left anterior descending coronary artery (LITA–LAD) graft, coupled with proven long-term survival benefits, has led to its becoming a ‘golden standard’ of CABG. Previous long-term studies have also shown unsatisfactory patency of saphenous vein grafts used for myocardial revascularization, compared with internal thoracic artery grafts. Thus, the use of arterial conduits has expanded beyond the internal thoracic arteries (ITAs) to include the right gastroepiploic artery, the inferior epigastric artery, and the radial artery. The assumption is that although the performance of one or two arterial ITA graft is superb, more arterial grafts should perform better in the long-term follow-up. Several studies concerning the use of the radial artery bypass grafts have documented excellent clinical results and satisfactory short-term as well as mid-term patency rates at restudy angiography, supporting its continued use as a bypass conduit. However, a note of caution concerning radial artery conduit patency rate have appeared in few recent reports. Thus, in this paper, we summarize the current evidence about the radial artery as a conduit in CABG surgery, with special emphasis on the clinical results.

Key Words: CABG • Surgery • Arterial grafts

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