LONG-TERM RESULTS OF CORONARY ARTERY BYPASS GRAFTING USING THE RADIAL ARTERY AND VENA CEPHALICA ISOLATED ON ONE FOREARM IN A PATIENT WITH LIMITED CONDUIT SELECTION
https://doi.org/10.57256/2949-0715-2026-5-2-83-89
Abstract
Background. Bypass graft selection is one of the most debated and unresolved issues in coronary surgery. The use of the left internal mammary artery for bypass grafting the left anterior descending coronary artery is the "gold standard," but the question of second- and third-order conduits arises. Conduits from the right internal mammary artery, radial artery, right gastroepiploic artery, and, rarely, the inferior epigastric and splenic arteries are considered. Arterial bypass grafts have varying long-term patency results. The great saphenous vein is frequently used, while the umbilical and cephalic veins are less commonly used. The proven advantages of arterial bypass grafts over venous ones often cannot be realized in practice in some patients due to various circumstances.
The aim of this report is to demonstrate the long-term results of coronary artery bypass grafting using the radial artery and cephalic vein isolated in one forearm in a patient with limited conduit selection.
Case descriptions. In conditions of limited choice of conduit for a patient during coronary artery bypass grafting, the radial artery and cephalic vein, isolated on one forearm, were used. Satisfactory patency of the shunts was demonstrated 3.9 years after surgery.
Conclusion. The conclusion result allows us to consider this bypass method acceptable in the absence of other conduits.
About the Author
Vladimir A. Podkamenny
Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy
of Continuing Professional Education;
Irkutsk Regional Clinical Hospital
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, Department of Surgery, Cardiovascular Surgery, and Clinical Angiology;
Cardiovascular Surgeon
References
1. Alboom M., Browne A., Sheth T. et al. Conduit selection and early graft failure in coronary artery bypass surgery: A post hoc analysis of the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) coronary artery bypass grafting study. J Thorac Cardiovasc Surg. 2023;165(3):1080-1089.e1. https://doi.org/10.1016/j.jtcvs.2022.05.028.
2. Gaudino M., Di Franco A., Bhatt D.L. et al. The association between coronary graft patency and clinical status in patients with coronary artery disease. Eur Heart J 2021;42:1433–41. https://doi.org/10.1093/eurheartj/ehab096
3. Подкаменный В.А., Желтовский Ю.В., Шаравин А.А. и др. Головная вена (vena cephalica) как резервный кондуит при операциях коронарного шунтирования у больных ИБС. Сибирский медицинский журнал (Иркутск). 2016;142(3):22-25 [Podkmenny V.A., Zheltovskiy U.V., Sharavin A.A. et al. Using of cephalic vein as reserve conduit in coronary artery bypass grafting. Sibirskij medicinskij zurnal (Irkutsk). 2016;142(3):22-25 (In Russ.)]. URL: https://cyberleninka.ru/article/n/golovnaya-vena-vena-cephalica-kak-rezervnyy-konduit-pri-operatsiyah-koronarnogo-shuntirovaniya-u-bolnyh-ibs [accessed 16.03.2026]
4. Thuan P.Q., Chuong P.T.V., Nam N.H., Dinh N.H. Coronary Artery Bypass Surgery: Evidence-Based Practice. Cardiol Rev. 2025;33(4):344-351. https://doi.org/10.1097/CRD.0000000000000621
5. Sabik J.F. 3rd, Lytle B.W., Blackstone E.H., Houghtaling P.L., Cosgrove D.M. Comparison of saphenous vein and internal thoracic artery graft patency by coronary system. Ann Thorac Surg. 2005;79(2):544-551. https://doi.org/10.1016/j.athoracsur.2004.07.047
6. Yokoyama Y., Takagi H., Kuno T. Graft Patency of a Second Conduit for Coronary Artery Bypass Surgery: A Network Meta-Analysis of Randomized Controlled Trials. Semin Thorac Cardiovasc Surg. 2022;34(1):102-109. https://doi.org/10.1053/j.semtcvs.2021.02.002
7. Ozkan S., Akay T.H., Gultekin B. et al. Atherosclerosis of radial and internal thoracic arteries used in coronary bypass: atherosclerosis in arterial grafts. J Card Surg. 2007;22(5):385-9). https://doi.org/10.1111/j.1540-8191.2007.00431.x
8. Barner H.B. Conduits for Coronary Bypass: Arteries Other Than the Internal Thoracic Artery's. Korean J Thorac Cardiovasc Surg. 2013;46(3):165-177. https://doi.org/10.5090/kjtcs.2013.46.3.165
9. Gaudino M., Audisio K., Di Franco A. et al. Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting. Eur J Cardiothorac Surg. 2022;62(1):ezac345. https://doi.org/10.1093/ejcts/ezac345
10. Buxton B.F., Raman J.S., Ruengsakulrach P. et al. Radial artery patency and clinical outcomes: five-year interim results of a randomized trial. J Thorac Cardiovasc Surg. 2003;125(6):1363-1371. https://doi.org/10.1016/s0022-5223(02)73241-8
11. Deb S., Cohen E.A., Singh S.K. et al. 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;60(1):28-35. https://doi.org/10.1016/j.jacc.2012.03.037.
12. Maestri F., Formica F., Gallingani A., Gripshi F., Nicolini F. Radial Artery Versus Saphenous Vein as Third Conduit in Coronary Artery Bypass Graft Surgery for Multivessel Coronary Artery Disease: a Ten-Year Literature Review. Acta Biomed. 2022;93(2):e2022049. https://doi.org/10.23750/abm.v93i2.11370
13. He G.W. Arterial grafts: clinical classification and pharmacological management. Ann Cardiothorac Surg. 2013;2(4):507-518. https://doi.org/10.3978/j.issn.2225-319X.2013.07.12
14. Neumann F.J., Sousa-Uva M., Ahlsson A. et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40(2):87-165. https://doi.org/10.1093/eurheartj/ehy394
15. Purohit M., Dunning J. Do coronary artery bypass grafts using cephalic veins have a satisfactory patency? Interact Cardiovasc Thorac Surg. 2007;6(2):251-254. https://doi.org/10.1510/icvts.2006.149104
16. Wijnberg D.S., Boeve W.J., Ebels T. et al. Patency of arm vein grafts used in aorto-coronary bypass surgery. Eur J Cardiothorac Surg. 1990;4(9):510-513. https://doi.org/10.1016/1010-7940(90)90176-z
Review
For citations:
Podkamenny V. LONG-TERM RESULTS OF CORONARY ARTERY BYPASS GRAFTING USING THE RADIAL ARTERY AND VENA CEPHALICA ISOLATED ON ONE FOREARM IN A PATIENT WITH LIMITED CONDUIT SELECTION. Baikal Medical Journal. 2026;5(2):83-89. (In Russ.) https://doi.org/10.57256/2949-0715-2026-5-2-83-89
Views:
111
JATS XML
