Skeletonized radial artery: New technique for graft harvest with improved angiographic results

Abstract

To improve the patency rate of radial artery grafts, we have been using a skeletonized harvesting technique since September 2000. Our early reports confirmed better graft patency of skeletonized radial graft compared to conventional pedicled grafts. We present the angiographic and clinical follow-up data on skeletonized radial artery grafting. Between 09/01/2000 and 7/31/2002, a total of 268 patients underwent isolated coronary artery bypass using skeletonized radial artery graft, excluding T-grafting. Of these, 216 (80.6%) patients underwent postoperative angiography and their perioperative, early angiographic, and follow-up results were analyzed. There was 1 hospital death and 6 incidences of postoperative myocardial infarction. None were related to radial artery bypass. Early angiographic control revealed that the stenosis-free graft patency rate of radial artery anastomoses (318/331, 96.1%) was not significantly different from other conduits (the left internal mammary artery 93.5%, right internal mammary artery 90.8%, gastroepiploic artery 96.3%, and saphenous vein 97.6%). Follow-up was completed for all hospital survivors with a mean follow-up of 1.6 ± 0.4 years. There were no cardiac deaths, and 9 cardiac events, giving a cardiac event-free rate of 95.8%. The angiographical patency of the skeletonized radial artery was excellent. Although cardiac events were minimal, follow-up mid-term angiographics will be necessary to confirm our clinical outcome data.