Iacò A L, Teodori G, Di Giammarco G, Di Mauro M, Storto L, Mazzei V, Vitolla G, Mostafa B, Calafiore A M
Department of Cardiology, University G D'Annunzio, Chieti, Italy.
Ann Thorac Surg. 2001 Aug;72(2):464-8; discussion 468-9. doi: 10.1016/s0003-4975(01)02758-8.
To evaluate the long-term clinical and angiographic results of the radial artery (RA) as a graft in coronary artery bypass surgery.
One hundred sixty-four patients had a RA graft from July 1992 to July 1994. In 128 (group A) the RA was connected end to side (115) or end to end (13) to the left internal mammary artery. In 36 (group B) the proximal anastomosis was on the ascending aorta.
Early mortality was 1.8% (group A 1.6% and group B 2.8%). Eight-year survival was 83.2%+/-3.2% (group A 82.1%+/-3.8% and group B 86.7%+/-6.2%, p = not significant [NS]), and event free survival was 80.1%+/-3.5% (group A 79.9%+/-4.4% and group B 80.2%+/-7.3%, p = NS). Sixty-one patients (37.2%) had an early angiography within 90 days from the operation. Patency rate of RA distal anastomoses were 98.9% (88 of 89), 98.7% in group A (77 of 78), 100% in group B (11 of 11; p = NS). After a mean of 48+/-27 months (6 to 96), 72 patients (51.1% of the survivors) had a new angiography. Patency rate of RA distal anastomoses was 95.6% (87 of 91), 93.8% in group A (61 of 65) and 100% in group B (26 of 26; p = NS). All the intermediate RA-LIMA anastomoses were patent at the early and late control. Patency rate for RA and IMAs was similar both early (88 of 89 versus 82 of 82; p = NS) and after 48+/-27 months (87 of 91 versus 93 of 93; p = NS).
Long-term clinical results after RA grafting are satisfying. Angiographic patency rate, both early and after 48 months, is higher than 90% and is similar to that obtained with internal mammary arteries. The site of the proximal anastomosis does not influence early and late patency.
评估桡动脉（RA）作为冠状动脉搭桥手术移植物的长期临床和血管造影结果。
1992年7月至1994年7月，164例患者接受了桡动脉移植。其中128例（A组）桡动脉与左乳内动脉端侧吻合（115例）或端端吻合（13例）。36例（B组）近端吻合口位于升主动脉。
早期死亡率为1.8%（A组1.6%，B组2.8%）。8年生存率为83.2%±3.2%（A组82.1%±3.8%，B组86.7%±6.2%，p = 无显著性差异[NS]），无事件生存率为80.1%±3.5%（A组79.9%±4.4%，B组80.2%±7.3%，p = NS）。61例患者（37.2%）在术后90天内进行了早期血管造影。桡动脉远端吻合口通畅率为98.9%（89例中的88例），A组为98.7%（78例中的77例），B组为100%（11例中的11例；p = NS）。平均48±27个月（6至96个月）后，72例患者（幸存者的51.1%）进行了新的血管造影。桡动脉远端吻合口通畅率为95.6%（91例中的87例），A组为93.8%（65例中的61例），B组为100%（26例中的26例；p = NS）。所有中间的桡动脉-乳内动脉吻合口在早期和晚期检查时均通畅。桡动脉和乳内动脉的通畅率在早期（89例中的88例对82例中的82例；p = NS）和48±27个月后（91例中的87例对93例中的93例；p = NS）相似。
桡动脉移植后的长期临床结果令人满意。血管造影通畅率在早期和48个月后均高于90%，与乳内动脉相似。近端吻合口的位置不影响早期和晚期通畅率。
