An unexpected complication after harvesting of the radial artery for coronary artery bypass grafting.

Acute ischemia of the hand developed after coronary artery bypass grafting with a radial artery conduit. Perioperative tests established that there was good perfusion to the hand via the collateral vessels. Angiographic examination showed an absence of the ulnar artery. Circulation was restored with a vein graft. I briefly review noninvasive investigations available and suggest that color Doppler scanning should be routinely performed before the use of the radial artery as a conduit.