Does Previous Transradial Catheterization Preclude Use of the Radial Artery as a Conduit in Coronary Artery Bypass Surgery?

The radial artery (RA) is a commonly used conduit for coronary artery bypass grafting (CABG), and recent studies have demonstrated that it provides superior long-term patency rates to the saphenous vein in most situations. In addition, the RA is also being used with increasing frequency as the access point for coronary angiography and percutaneous coronary interventions. However, there has been concern for many years that these transradial procedures may have a detrimental impact on the function of RA grafts used in CABG, and there is now comprehensive evidence that transradial procedures cause morphological and functional damage to the artery in situ. Despite this, there have been remarkably few studies examining the impact of previous catheterization on RAs used as CABG conduits, although those that have been carried out have demonstrated a significant reduction in the patency of grafts from previously catheterized RAs. This presentation will concisely review the evidence that transradial procedures cause damage to the RA, and discuss the impact this could have on previously cannulated RAs used as CABG conduits. On the basis of the evidence assessed, we make a number of recommendations to both surgeons and cardiologists regarding use of the RA in cardiovascular procedures.