Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
J Card Surg. 2021 Dec;36(12):4796-4798. doi: 10.1111/jocs.16049. Epub 2021 Oct 9.
The radial artery (RA) is often utilized for diagnostic coronary angiography and percutaneous intervention. Recent high-level evidence supports RA use in preference to the saphenous vein as a conduit for coronary revascularization.
To demonstrate gross and histologic changes of the RA following transradial (TR) access.
We present two patients who had open RA harvest for coronary bypass surgery after TR catheterization.
Examination 8 years after TR catheterization demonstrated thickened intima and dissection, and examination 12 years following TR catheterization with percutaneous coronary intervention demonstrated chronic dissection with thickened intima and near occlusion of the lumen.
TR access via the RA, even after several years, is associated with significant injury, making it unusable as a conduit for surgical coronary revascularization. A RA that has been utilized for catheterization should not be considered for coronary revascularization.
桡动脉（RA）常用于诊断性冠状动脉造影和经皮介入治疗。最近的高级别证据支持将 RA 用于冠状动脉血运重建，而不是作为导管的隐静脉。
展示经桡动脉（TR）入路后 RA 的大体和组织学变化。
我们介绍了两位患者，他们在 TR 导管插入后接受了开放式 RA 采集用于冠状动脉旁路手术。
TR 导管插入 8 年后的检查显示内膜增厚和夹层，TR 导管插入并进行经皮冠状动脉介入治疗 12 年后的检查显示慢性夹层，内膜增厚，管腔接近闭塞。
即使经过数年，TR 通过 RA 的入路也与明显的损伤相关，使其不能用作外科冠状动脉血运重建的导管。已经用于导管插入术的 RA 不应考虑用于冠状动脉血运重建。
