The Radial Artery in Coronary Surgery – Our Initial Clinical Experience

Objective: We compared in our experience the radial artery harvested in the skeletonized versus pedicled manner as an additional arterial graft for coronary surgery.
Material and methods: In this study we evaluated the results obtained of 47 patients to whom we harvested the radial artery using skeletonized technique (14 cases) and pedicled technique (33 cases). In all the cases, preoperatively the radial artery was evaluated by using the modified Allen test, echo Duplex and angio CT, intraoperative the grafts were used for grafting the circumflex and right coronary system grafting and postoperative the patients were evaluated clinically and angiographically.
Results: The age was situated in between 36–77 years. The harvest time was comparable for both methods (mean 42 minutes vs 34 minutes), the length of the conduit was also comparable (mean 14.4 cm vs 13.9 cm) and without having local complication in both techniques, but the diameter of the graft and its uniformity was greater with the “pedicled” method (mean 3 mm vs 2.2 mm). The function of the grafts was good in both circumflex and right coronary systems, with corresponding values measured at the end of the operation: flow 21–67 ml/min (mean) and pulsatility index 1.3–3.9 (mean). There were no complications at the harvest site and the patients were free from angina after the operation, the angiographic control demonstrating a good function of the grafts in both groups.
Conclusions: The “pedicled” surgical harvest of the radial artery offers an arterial graft with a superior and uniform diameter associated with a corresponding length for the patients with total arterial myocardial revascularization.