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Randomized Controlled Trial
. 2014 May;102(5):441-8.
doi: 10.5935/abc.20140016.

Effects of skeletonized versus pedicled radial artery on postoperative graft patency and flow

[Article in English, Portuguese]
Rômulo C Arnal Bonini  1 , Rodolfo Staico  2 , Mario Issa  2 , Antoninho Sanfins Arnoni  2 , Paulo Chaccur  2 , Camilo Abdulmassih Neto  2 , Jarbas Jackson Dinkhuysen  2 , Paulo Paredes Paulista  2 , Luiz Carlos Bento de Souza  2 , Luiz Felipe P Moreira  1
Affiliations
Randomized Controlled Trial

Effects of skeletonized versus pedicled radial artery on postoperative graft patency and flow

[Article in English, Portuguese]
Rômulo C Arnal Bonini et al. Arq Bras Cardiol. 2014 May.

Abstract

Background: Radial artery (RA) was the second arterial graft introduced in clinical practice for myocardial revascularization. The skeletonization technique of the left internal thoracic artery (LITA) may actually change the graft's flow capacity with potential advantages. This leads to the assumption that the behavior of the RA, as a coronary graft, is similar to that of the LITA, when skeletonized.

Objective: This study evaluated 'free' aortic-coronary radial artery (RA) grafts, whether skeletonized or with adjacent tissues.

Methods: A prospective randomized study comparing 40 patients distributed into two groups was conducted. In group I, we used skeletonized radial arteries (20 patients), and in group II, we used radial arteries with adjacent tissues (20 patients). After the surgical procedure, patients underwent flow velocity measurements.

Results: The main surgical variables were: RA internal diameter, RA length, and free blood flow in the radial artery. The mean RA graft diameters as calculated using quantitative angiography in the immediate postoperative period were similar, as well as the flow velocity measurement variables. On the other hand, coronary cineangiography showed the presence of occlusion in one RA graft and stenosis in five RA grafts in GII, while GI presented stenosis in only one RA graft (p = 0.045).

Conclusion: These results show that the morphological and pathological features, as well as the hemodynamic performance of the free radial artery grafts, whether prepared in a skeletonized manner or with adjacent tissues, are similar. However, a larger number of non-obstructive lesions may be observed when RA is prepared with adjacent tissues.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Pedicled radial artery with non-obstructive lesion in the proximal third.
Figure 2
Figure 2
Pedicled radial artery proximally occluded.
Figure 3
Figure 3
Mean proximal internal angiographic diameter of the radial artery (p = 0.492). Mean ± 95% CI.
Figure 4
Figure 4
Coronary Flow Reserve of the radial artery (p = 0.624). Mean ± 95%CI.
Figure 5
Figure 5
Blood flow of the radial artery at rest (p = 0.435). Mean ± 95% CI.
See this image and copyright information in PMC

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