» Articles » PMID: 15511443

Histopathology and Morphometry of Radial Artery Conduits: Basic Study and Clinical Application

Overview
Journal Ann Thorac Surg
Publisher Elsevier
Date 2004 Oct 30
PMID 15511443
Citations 27
Authors
Affiliations
Soon will be listed here.
Abstract

Background: The purpose of this study was to determine the pathohistology, morphometry, and risk factors for the development of intimal hyperplasia, calcification, and arteriosclerosis in the radial artery and to compare the morphometry of the distal and proximal radial arteries.

Methods: A total of 190 proximal and distal radial artery specimens obtained from patients who underwent myocardial revascularization were exposed to histopathologic and morphometric analysis. The severity of disease was evaluated on the basis of the percentage of luminal narrowing, intimal thickness index, and intima-to-media ratio.

Results: Sixty-two proximal (32.6%) and 22 distal (11.5%) radial artery segments were indicated as histologically normal. Morphometric analysis (Z test) revealed a lesser degree of intimal hyperplasia and luminal narrowing in the proximal segments compared with the distal segments (p < 0.001). The incidence of intimal hyperplasia, medial calcification, and arteriosclerosis in the distal radial arteries was 76.3%, 6.3%, and 5.78%, respectively. Using multivariate logistic regression, we have identified three significant predictors for intimal hyperplasia. Expressed as an odds ratio with a 95% confidence interval, these included (i) age greater than 50 years (1.052; 1.000-1.106, p = 0.052), (ii) smoking (14.073; 5.293-37.414, p = 0.000), and (iii) hypertension (2.777; 1.171-6.583, p = 0.020). Factors associated with an increased likelihood of medial calcification and arteriosclerosis included a history of smoking, diabetes, hypercholesterolemia, peripheral arterial disease, and chronic renal failure (p < 0.05).

Conclusions: The great majority of radial artery conduits indicate preexisting intimal hyperplasia mostly affecting the distal portion. Therefore in cases of longer diseased segments of radial arteries, the discarded segments should be the distal end. Care should be taken when selecting radial artery as a conduit in myocardial revascularization, particularly in elderly males, diabetics, smokers, hypertensive patients, and in those with associated peripheral vascular disease.

Citing Articles

To reverse or not to reverse the radial artery in coronary artery bypass graft surgery? Histopathologic concerns and media thickness.

Mir Mohammad Sadeghi P, Mir Mohammad Sadeghi M, Derakhshan M, Mir Mohammad Sadeghi A, Kazemian A, Abbasivand A Heliyon. 2023; 9(10):e20873.

PMID: 37867848 PMC: 10585284. DOI: 10.1016/j.heliyon.2023.e20873.


Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease.

Hutcheson J, Goettsch C Circ Res. 2023; 132(8):993-1012.

PMID: 37053279 PMC: 10097496. DOI: 10.1161/CIRCRESAHA.123.321760.


Assessment of radial artery atherosclerosis in acute coronary syndrome patients: an in vivo study using optical coherence tomography.

Li Z, Tang Z, Wang Y, Liu Z, Wang G, Zhang L BMC Cardiovasc Disord. 2022; 22(1):120.

PMID: 35313827 PMC: 8939080. DOI: 10.1186/s12872-022-02561-5.


Impact of prediabetes and duration of diabetes on radial artery atherosclerosis in acute coronary syndrome patients: An optical coherence tomography study.

Li Z, Tang Z, Wang Y, Liu Z, Wang S, Wang Y Diab Vasc Dis Res. 2022; 19(1):14791641221078108.

PMID: 35184608 PMC: 8866250. DOI: 10.1177/14791641221078108.


Different Lower Extremity Arterial Calcification Patterns in Patients with Chronic Limb-Threatening Ischemia Compared with Asymptomatic Controls.

Konijn L, Takx R, Mali W, Veger H, van Overhagen H J Pers Med. 2021; 11(6).

PMID: 34072908 PMC: 8226835. DOI: 10.3390/jpm11060493.