Coronary artery bypass grafting (CABG) is the standard surgical procedure for the treatment of advanced coronary artery disease. CABG surgery has been demonstrated to improve symptoms and, in specific subgroups of patients, to prolong life. Despite its success, the long-term outcome of coronary bypass surgery is strongly influenced by the fate of the vascular conduits used. Impressive long-term disease-free patency rate of the left internal thoracic artery-left anterior descending coronary artery (LITA-LAD) graft, coupled with proven long-term survival benefits, has led to its becoming a 'golden standard' of CABG. Previous long-term studies have also shown unsatisfactory patency of saphenous vein grafts used for myocardial revascularization, compared with internal thoracic artery grafts. Thus, the use of arterial conduits has expanded beyond the internal thoracic arteries (ITAs) to include the right gastroepiploic artery, the inferior epigastric artery, and the radial artery. The assumption is that although the performance of one or two arterial ITA graft is superb, more arterial grafts should perform better in the long-term follow-up. Several studies concerning the use of the radial artery bypass grafts have documented excellent clinical results and satisfactory short-term as well as mid-term patency rates at restudy angiography, supporting its continued use as a bypass conduit. However, a note of caution concerning radial artery conduit patency rate have appeared in few recent reports. Thus, in this paper, we summarize the current evidence about the radial artery as a conduit in CABG surgery, with special emphasis on the clinical results.

译文

:冠状动脉搭桥术(CABG)是用于治疗晚期冠状动脉疾病的标准手术方法。已经证明,CABG手术可以改善症状,并在特定的患者亚组中可以延长寿命。尽管取得了成功,但冠状动脉搭桥手术的长期结果在很大程度上受到所用血管导管命运的影响。左胸内动脉-左冠状动脉前降支(LITA-LAD)移植物令人印象深刻的长期无病通畅率,加上已证明的长期生存优势,使其成为CABG的“黄金标准”。先前的长期研究还显示,与胸腔内动脉移植相比,用于心肌血运重建的大隐静脉移植物的通畅性不令人满意。因此,动脉导管的用途已扩展到胸内动脉(ITAs)之外,以包括右胃上皮动脉,胃下腹动脉和radial动脉。假设是,尽管一或两个动脉ITA移植物的性能极佳,但在长期随访中,更多的动脉移植物应表现更好。有关使用the动脉旁路移植物的几项研究已记录了出色的临床结果,以及在重新研究血管造影术时令人满意的短期和中期通畅率,支持其继续用作旁路导管。然而,在最近的报道中很少出现关于radial动脉导管通畅率的注意事项。因此,在本文中,我们总结了有关the动脉作为CABG手术导管的当前证据,并特别强调了临床结果。

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