da Costa F D, da Costa I A, Poffo R, Abuchaim D, Gaspar R, Garcia L, Faraco D L
Department of Cardiac Surgery of the Santa Casa, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil.
Ann Thorac Surg. 1996 Aug;62(2):475-9; discussion 479-80.
It has been well documented that the use of the internal thoracic artery yields better long-term patency rates than saphenous vein grafts for coronary artery bypass grafting. This knowledge has prompted surgeons to use other arterial conduits such as the radial artery.
Between April 1994 and January 1996, radial artery grafts were used in 83 patients (mean age, 54.6 years) undergoing myocardial revascularization. All patients received diltiazem, 80 mg orally three times daily. Angiographic studies were performed in the early post-operative period in 61 patients, and 6 to 19 months later in 12 patients.
There were four hospital deaths (4.8%), none of them due to cardiac causes. Perioperative myocardial infarction was observed in 3 patients, 1 related to a radial artery graft occlusion. Of 61 grafts studied early, 59 were patent (96.7%), but two grafts showed diffuse spasm. Twelve patients had a second angiogram after a mean interval of 8.7 months, and all grafts were patent. One patient who had a diffuse spasm at the early study had recurrent symptoms, and repeat angiogram showed further narrowing of the graft (string sign).
Our results suggest that with proper care, the radial artery may be used for coronary artery bypass grafting with good early results. Long-term follow-up and angiography studies will be needed to establish the merit of the radial artery as a graft for coronary artery operations.
有充分的文献记载，在冠状动脉旁路移植术中，使用胸廓内动脉比使用大隐静脉移植具有更好的长期通畅率。这一认识促使外科医生使用其他动脉血管移植物，如桡动脉。
在1994年4月至1996年1月期间，83例（平均年龄54.6岁）接受心肌血运重建的患者使用了桡动脉移植物。所有患者均口服地尔硫䓬，每日3次，每次80毫克。61例患者在术后早期进行了血管造影研究，12例患者在6至19个月后进行了血管造影研究。
有4例医院死亡（4.8%），均非心脏原因所致。3例患者发生围手术期心肌梗死，1例与桡动脉移植物闭塞有关。在早期研究的61例移植物中，59例通畅（96.7%），但2例移植物出现弥漫性痉挛。12例患者在平均8.7个月的间隔后进行了第二次血管造影，所有移植物均通畅。1例在早期研究中出现弥漫性痉挛的患者出现复发症状，重复血管造影显示移植物进一步狭窄（串珠征）。
我们的结果表明，在适当的护理下，桡动脉可用于冠状动脉旁路移植术，早期效果良好。需要进行长期随访和血管造影研究，以确定桡动脉作为冠状动脉手术移植物的优点。
