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Abstract
The radial artery has recently been an alternate arterial conduit for myocardial revascularization coming as a second choice after left internal mammary artery with higher patency rates and superior flow characteristics than saphenous vein.
Radial artery harvesting is technically easier than other arterial grafts with no major hand or forearm morbidity.
However, establishment of the safety of radial artery removal is important because of the increased use of this artery as a bypass conduit in coronary artery bypass grafting.
Assessment of collateral hand blood supply is a very important step to prevent symptoms of hand or digital ischaemia. This can be done by Allen’s test, pulse oximetry and duplex scanning. Allen’s test is subjective, observer dependant and there is no “print-out” of standard results giving false positive and false negative results yet it’s still a good screening test. Duplex ultrasound appears to be the best method for patient selection as it has the ability to detect any congenital, anatomical and pathological abnormalities with arterial system also it can assess the physiologic adaptation of the vessels after radial artery compression.
Proper patient selection with pre-operative assessment of collateral ulnar blood flow to the forearm and the hand in addition to no touch, atraumatic harvesting makes the radial artery safe to use routinely as bypass graft with no early or late Ischaemic or functional forearm disability.