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Ann Thorac Surg 2005;79:99-103
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Intravascular Ultrasound Analysis of the Radial Artery for Coronary Artery Bypass Grafting

^a Department of Medicine (Cardiology), Teikyo University School of Medicine
^b Department of Medicine (Cardiology), International Medical Center of Japan, Tokyo, Japan

Accepted for publication June 25, 2004.

^* Address reprint requests to Dr Takeshita, Department of Medicine (Cardiology), International Medical Center of Japan, 1–21–1 Toyama, Shinjuku-ku, Tokyo 162–8655, Japan (E-mail: stake{at}muse.ocn.ne.jp).

BACKGROUND: The radial artery has become a popular conduit for coronary artery bypass surgery. However, limited information has been provided regarding the atherosclerotic nature of this artery, which may affect both the immediate intraoperative difficulties and long-term graft patency.

METHODS: We examined intravascular ultrasound (IVUS) images of the radial artery in patients with coronary artery diseases. Cross sections of the radial artery were assessed using the following factors: lumen diameter, lumen area, vessel diameter, vessel area, plaque area, percent plaque area, and extent of calcium deposition.

RESULTS: The IVUS images were obtained from radial arteries of 58 patients (47 men, average 67 ± 9 years) during transradial procedures; ie, transradial coronary angiography and/or transradial coronary intervention. Mean luminal diameter was 3.28 ± 0.69 mm and 3.00 ± 0.70 mm at the proximal and distal segments, respectively, and 2.58 ± 0.73 mm at the minimal lumen cross section. A percent plaque area greater than 50% was seen in five radial arteries (8.6%) whose average plaque length was 26.4 ± 30.8 mm. Of these, one showed a plaque length greater than 50 mm, and another showed vessel caliber less than 2.0 mm. Five of 58 radial arteries (8.6%) showed calcium deposition, two of which showed diffuse calcification (> 50 mm). Thus, among 58 radial arteries, four (6.9%: one with diffuse arteriosclerosis, one small radial artery, two with diffuse calcification) were considered unsuitable for bypass conduit.

CONCLUSIONS: Preoperative evaluation of the radial artery is recommended in order to prevent unnecessary exploration of the forearm and to improve graft patency.

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