Radial artery – perspective or fallacy?

Abstract

Highlights. Radial artery is the second after internal thoracic artery by frequency of use among all of autogenous arterial conduits. Some modern studies indicate the superiority of this conduit to autogenous venous conduits; however, it remains an ongoing discussion.The article presence an analytical review regarding the use of the radial artery as one of conduits during coronary artery bypass grafting. Historical and contemporary perspectives of its use are given, examples of large-scale studies and results are provided, including the “graft-artery junction” concept.Abstract. Radial artery (RA) is the second after internal thoracic artery (ITA) by frequency of use among all of autogenous arterial conduits in coronary artery bypass grafting (CABG), however it is used in less than 13% of cases. The story of RA as a conduit starts in the 1970s, when the famous French surgeon, founder of modern mitral valve repair Alain Frédéric Carpentier proposed to use it. During the development of cardiovascular surgery, RA was actively introduced as a conduit for CABG, and nowadays there are both supporters and opponents of its application. On the one hand, long-term results of CABG with RA are superior to CABG with autogenous venous conduits, whereas the patency of RA is comparable with ITA. On the other hand, RA demonstrates worse angiographic indicators, which could be explained by a diffuse narrowing resulting in complete occlusion; such phenomenon is entitled “string-sign”. Moreover, as in case with other conduits, the site of proximal anastomosis, and harvesting method (open or endoscopic) play an important role in the long-term RA functioning and its resistance to atherosclerosis in grafted coronary arteries, thus making RA a good target for studing and predetermining new perspectives of its use.