Brodman R F, Frame R, Camacho M, Hu E, Chen A, Hollinger I
Department of Cardiothoracic Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.
J Am Coll Cardiol. 1996 Oct;28(4):959-63. doi: 10.1016/s0735-1097(96)00265-3.
This study sought to evaluate the routine use of radial artery (RA) grafts in patients undergoing coronary artery revascularization.
Previous long-term studies have documented poor patency of saphenous vein grafts compared with internal thoracic artery (ITA) grafts.
We performed a prospective review of 175 of 249 consecutive patients.
Fifty-four patients had bilateral RAs harvested. Mean number (+/- SD) of grafts/patient was 3.27 +/- 0.93, with 2.76 +/- 0.97 arterial grafts; a mean of 1.53 +/- 0.68 grafts were performed with the RA. The operative mortality rate was 1.6%. No deaths were related to RA grafts, and there were no RA harvest site hematomas or infections. Transient dysesthesia 1 day to 4 weeks in duration occurred in the distribution of the lateral antebrachial cutaneous nerve in six extremities (2.6%). Elective cardiac catheterization in 60 patients at 12 weeks postoperatively demonstrated a 95.7% patency rate.
Because of potential benefit of long-term patency associated with arterial grafts, minimal morbidity and mortality associated with use of the RA and excellent short-term patency rates, we cautiously recommend use of one or both RAs as additional conduits to be used concomitantly with the ITA for arterial revascularization of the coronary arteries.
本研究旨在评估冠状动脉血运重建患者桡动脉（RA）移植物的常规使用情况。
先前的长期研究表明，与胸廓内动脉（ITA）移植物相比，大隐静脉移植物的通畅率较差。
我们对连续249例患者中的175例进行了前瞻性回顾。
54例患者双侧桡动脉被采集。每位患者移植物的平均数量（±标准差）为3.27±0.93，其中动脉移植物为2.76±0.97；平均1.53±0.68个移植物采用桡动脉。手术死亡率为1.6%。无死亡与桡动脉移植物相关，且无桡动脉采集部位血肿或感染。6例肢体（2.6%）在前臂外侧皮神经分布区域出现持续1天至4周的短暂感觉异常。术后12周对60例患者进行选择性心导管检查，显示通畅率为95.7%。
由于动脉移植物具有长期通畅的潜在益处、使用桡动脉相关的发病率和死亡率极低以及短期通畅率极佳，我们谨慎推荐使用一根或两根桡动脉作为与胸廓内动脉同时使用的额外血管，用于冠状动脉的动脉血运重建。
