Can Radial Artery be Used as Conduit for CABG After Transradial Coronary Angiography?

Can Radial Artery be Used as Conduit for CABG After Transradial Coronary Angiography?

Radial artery is being increasingly used as a conduit for coronary artery bypass grafting in multi-vessel coronary artery disease as it provides superior long term patency rates compared to saphenous vein grafts [1]. Radial artery is also increasingly being used as access point for coronary angiography and percutaneous coronary interventions. Concerns have been raised regarding the use of radial artery as conduit after transradial procedures as there is likelihood of vascular trauma during the procedures.

Some authors even mention that prior transradial catheterization is a contraindication for the use of radial artery for CABG because of high rates of structural damage to the vessel wall and potential graft failure. In one study, two patients who had undergone transradial coronary angiography 8 and 12 years prior had chronic injury with dissection and obstruction of the lumen secondary to fibrosis. The authors suggested that transradial catheterization can cause long term and irreversible damage rendering them unsuitable as conduits for CABG [2].

References

1. Saswata Deb, Eric A Cohen, Steve K Singh, Dai Une, Andreas Laupacis, Stephen E Fremes, RAPS Investigators. Radial Artery and Saphenous Vein Patency More Than 5 Years After Coronary Artery Bypass Surgery. Results From RAPS (Radial Artery Patency Study). J Am Coll Cardiol. 2012 Jul 3;60(1):28-35.
2. Chadow D, Soletti GJ, Gaudino M. Never again. Once used for cardiac catherization the radial artery cannot be used for CABG. J Card Surg. 2021 Dec;36(12):4799-4800. doi: 10.1111/jocs.16045. Epub 2021 Oct 1. PMID: 34599522.