The radial artery (RA) has seen a recent resurgence in coronary artery bypass grafting (CABG) surgery. Recent randomized evidence has shown higher long-term patency rates and better clinical outcomes with the RA when compared to other conduits such as the right internal thoracic artery and saphenous vein grafts. In fact, the RA is now class I indication as the second conduit in CABG. Therefore, it is important that the coronary surgeon is familiar with the RA and its use in CABG. In this report we describe our operative technique for RA harvesting and use in CABG. As with any surgical procedure, patient selection is key. We describe our approach to screening including duplex ultrasonography and plethysmography, endoscopic and open harvesting techniques, preservation and grafting strategies, target vessel selection, and anastomotic techniques. The radial artery (RA) has seen a recent resurgence in coronary artery bypass grafting (CABG) surgery. Recent randomized evidence has shown higher long-term patency rates and better clinical outcomes with the RA when compared to other conduits such as the right internal thoracic artery and saphenous vein grafts. In fact, the RA is now class I indication as the second conduit in CABG. Therefore, it is important that the coronary surgeon is familiar with the RA and its use in CABG. In this report we describe our operative technique for RA harvesting and use in CABG. As with any surgical procedure, patient selection is key. We describe our approach to screening including duplex ultrasonography and plethysmography, endoscopic and open harvesting techniques, preservation and grafting strategies, target vessel selection, and anastomotic techniques. Commentary: Techniques Within Arm's ReachOperative Techniques in Thoracic and Cardiovascular SurgeryVol. 26Issue 4PreviewMultiple arterial revascularization (MAR) in coronary artery bypass grafting (CABG) has seen increased use1 for its mortality and morbidity benefits,2 and currently receives a IIa recommendation by the European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS). The radial artery (RA) has a ESC/EACTS Class I recommendation based on promising long-term clinical and patency outcomes.3 Dr. Mario Gaudino has contributed significantly to the current understanding of RA grafting and its’ acceptance as an excellent conduit choice. Full-Text PDF