Radial Artery Bypass Grafts Have an Increased Occurrence of Angiographically Severe Stenosis and Occlusion Compared With Left Internal Mammary Arteries and Saphenous Vein Grafts

Abstract

Background— The radial artery has been increasingly used in CABG. However, angiographic outcome data have been limited. Methods and Results— We reviewed all coronary angiography procedures from February 1996 to October 2001 and selected patients with a radial artery bypass graft. Angiographic outcomes were divided into groups as (1) occluded, (2) severe disease (≥70% stenosis, or string sign), or (3) patent (P P =0.0016). Radial artery grafts had an occlusion rate of 33.7%, compared with 4.8% for left internal mammary arteries ( P P =0.0003) and 4.8% for left internal mammary arteries ( P P =0.025). A radial artery graft was the most powerful multivariable predictor of severe stenosis or occlusion (χ ² =28.87, P Conclusions— In patients predominantly presenting with signs and symptoms of myocardial ischemia after CABG, radial artery grafts have lower patency rates than left internal mammary artery and saphenous vein grafts. Selective use of the radial artery is warranted, particularly in women.