Safety of the extended radial artery conduit in performing complete arterial revascularization

Purpose: We have developed a technique to elongate the radial artery (RA) with the distal segment of the left internal thoracic artery. This study investigated the safety and durability of this extended conduit compared with the composite Y-grafts. Methods: From January 1998 through December 2010, 750 patients underwent complete arterial revascularization with the use of the left internal thoracic artery (LITA) and RA. Out of these patients, 362 patients were operated on with the use of either RA-LITA extension conduit (n = 103), or a composite LITA-RA Y-graft (n = 259) and were included in this study. Cox regression analyses and Kaplan-Meyer survival curves were used to identify the predictive value of the RA-LITA extension technique on both survival and incidence of re-intervention. Results: Cox regression analysis showed that the use of RA-LITA extension conduit was not a significant predictor of re-intervention (p = 0.600) or total survival (p = 0.930). Kaplan-meier curves showed no significant difference between the two groups concerning total survival and re-intervention-free survival (p = 0.600). Conclusions: Our alternative technique of extending the RA with the distal segment of the LITA is a safe alternative for patients undergoing total arterial revascularization. The long-term survival and incidence of re-intervention is comparable with the composite LITA-RA Y-grafts.

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