Late haemodynamic and functional consequences of radial artery removal on the forearm circulation.

Overview

BACKGROUND: We aimed at evaluating the late haemodynamic and functional consequences on the forearm circulation of radial artery removal for coronary artery bypass grafting. METHODS: Ten years after surgery we performed basal and stress echo-Doppler evaluation of the forearm circulation, baseline and stress transcutaneous oxymetry and determination of reactive oxygen metabolites in the operated and control arm in 20 asymptomatic patients submitted to radial artery removal. RESULTS: The peak systolic velocity of the ulnar artery of the operated side was significantly higher than the control site. Transcutaneous oxymetry revealed asymptomatic hand ischemia at moderate level of muscular effort in the operated arm, but reactive oxygen metabolites measurement did not differ between the two arms. CONCLUSIONS: Even in patients with good ulnar compensation, radial artery removal leads to subtle degree of hand ischemia in conditions of sustained muscular effort. Although the clinical significance of this observation remains to be determined, this finding can have important implications for conduit selection in patients involved in manual activities.