Chronic compensatory increase in ulnar flow and accelerated atherosclerosis after radial artery removal for coronary artery bypass

Abstract

Only scant information is available on the chronic consequences of radial artery removal for coronary artery bypass surgery on forearm circulation. Twenty-five patients submitted to radial artery removal for coronary artery bypass were submitted to serial Doppler echocardiographic evaluation of the flow and morphology of the forearm arteries. The peak systolic velocity of the ulnar artery of the operated side was significantly higher than that of the control site. The intimal-medial thickness of the ulnar artery was always significantly higher on the operated side, and this difference reached statistical significance at 10 years' follow-up. There was a significantly higher prevalence of atherosclerotic plaques in the ulnar artery of the operated versus control arm (7/25 vs 0/25, P = .03). Radial artery removal for coronary artery bypass surgery leads to a chronic increase in ulnar flow accompanied by increased intimal-medial thickness and accelerated atherosclerotic disease. These findings might have potentially important implications for surgical indications and patient management.