Background: Multiple arterial myocardial revascularization seems to offer better long-term graft patency, lower incidence of major adverse cardiac and cerebrovascular events and better long-term survival compared to revascularization with usage of single arterial graft (1-3). Radial artery (RA) has shown to be an excellent choice for second arterial graft, with several benefits over alternative options. Here is presented the 20 years long experience of using radial artery in our Clinic.

Patients and Methods: In this retrospective study all patients in whom RA was used for surgical myocardial revascularization with multiple arterial grafts were included. Demographic and perioperative data, as well as transit-time flow measurement data were gathered from our Clinic’s database.

Results: There has been a total of 1421 RA grafts used in 1302 patients since 1998. The mean of distal anastomosis was 2.6±0.6 (2-5). Total arterial revascularization was achieved in 936 (72%) patients. In 66 patients (5%) additional procedure on aortic valve, mitral valve or left ventricle was performed. In 615 patients (half of patients with isolated coronary artery disease) revascularization was done as an off-pump CABG. There were no ischemic complications or postoperative wound infections. 2 patients (0.15%) had radial nerve injury. Radial artery grafts were mostly used in circumflex artery territory (641 grafts, 42%) and right coronary artery territory (599 grafts, 38%). Intraoperative transit-time flow measurements were routinely performed and showed excellent mean flow (46.6 ml/min), diastolic filling (62.9%) and pulsatility index (2.6).

Conclusion: Although this study does not provide any conclusions about long-term graft patency or patient survival, results for the past two decades show that radial artery can be routinely used in multiple arterial myocardial revascularization with exceedingly rare complications and excellent intraoperative flows.