Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway.
Scand Cardiovasc J. 2010 Aug;44(4):230-6. doi: 10.3109/14017431003699810.
The radial artery is resistant to atherosclerotic degeneration and therefore appears more attractive for coronary artery bypass grafting than the saphenous vein. However, the patency of radial artery grafts varies widely among studies. Therefore, before deciding whether to adopt this as the conduit of choice second to internal mammary artery grafts, we have prospectively monitored our first cohort of patients with radial-to-coronary bypasses.
Angiographic and clinical outcome parameters were registered for the 119 patients receiving radial artery grafts at our institution during April 4, 2001 to October 7, 2003.
Reangiography of 102 patients (86%) showed that after two to three years, 79% of the radial artery and 87% of the saphenous vein grafts remained patent. Radial artery harvesting was well tolerated. Patency of radial artery grafts was correlated to diabetes mellitus (detrimental), gender (women had higher occlusion rates), and use of angiotensin inhibiting medication (beneficial).
The pre-study assumption that radial artery grafts would out-perform those of saphenous vein at mid-term is not borne out. The propensity of radial artery graft failure in diabetics and the higher patency associated with angiotensin inhibition might both relate to endothelial modulation of the muscular tone of the graft.
与大隐静脉相比，桡动脉不易发生动脉粥样硬化退化，因此更适合用于冠状动脉旁路移植术。然而，桡动脉移植物的通畅率在不同研究之间差异很大。因此，在决定是否将其作为仅次于内乳动脉移植物的首选移植物之前，我们前瞻性地监测了我们第一组接受桡动脉旁路移植术的患者。
在 2001 年 4 月 4 日至 2003 年 10 月 7 日期间，我们机构为 119 名接受桡动脉移植的患者登记了血管造影和临床结果参数。
对 102 名患者（86%）进行再次血管造影，结果显示桡动脉和大隐静脉移植物在 2 至 3 年后分别有 79%和 87%保持通畅。桡动脉采集耐受良好。桡动脉移植物通畅性与糖尿病（不利）、性别（女性闭塞率更高）和血管紧张素抑制药物的使用（有益）相关。
在研究之前假设桡动脉移植物在中期会优于大隐静脉移植物的假设并未得到证实。糖尿病患者桡动脉移植物失败的倾向以及与血管紧张素抑制相关的更高通畅率可能都与移植物的内皮调节肌肉张力有关。
