Pathology of the radial and internal thoracic arteries used as coronary artery bypass grafts

Abstract

Background: This investigation compared the incidence and the degree of atherosclerosis present in radial artery (RA) and internal thoracic artery segments remaining after coronary artery bypass grafting.

Methods: One hundred seventy specimens from 102 patients were histologically analyzed, including 106 RA specimens.

Results: The mean degree of pathology for the RA was 0.89 on a 0 (none) to 4 (lumen completely obliterated) scale; the mean grade of pathology for the internal thoracic artery was 0.30 (p < 0.001). Presence of diabetes, aortofemoral disease, femoral-popliteal disease, age, and male gender correlated with an increase in RA pathology. Flow in the in situ RA did not correlate with the degree of pathology.

Conclusions: Study of the excess RA and internal thoracic artery segments remaining after coronary artery bypass grafting demonstrated that the RA had a higher degree of atherosclerosis than the internal thoracic artery at the time of harvest. Overall severity of disease in the RA was low. The long-term performance of RA grafts will determine whether this level of atherosclerotic disease has any clinical significance.