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The cardiac surgeons asked us about the use of the radial artery for bypass after transradial coronary cannulation
Name Dr Juan Caspar
Center Instituto Nacional de Cirurgia Cardiaca / Montevideo
Question Hello, we are the INCC, a cardiac cath.lab in Uruguay. Recently we received a visit of Dr. Hilton to our country and we assist at his conference. After that we are starting our learning curve with the radial approach for cardiac angiography and PTCA. The cardiac surgeons asked us about the use of the radial artery for bypass after catheterization. Do you have some information?
Answer At present no information is available on the long term effect on radial artery quality for bypass surgery following coronary cannulation with 6F sheaths or catheters for coronary cannulation. Since frequently one radial artery is used for bypass it can be advised to use the contralateral artery if of good quality. Presumably this is an interesting topic for further research. Why not performing a long-term (6 month) ultrasonic and/or angiographical study on radial artery quality following transradial procedures. An IVUS study will be of even greater value, since this will allow proper judgement on the radial artery intima. Perhaps a suggestion for a joint venture with other clinics performing transradial procedures.

Dr. Friedman replied 16/8/98:

I have currently performed over 200 transradial procedures including 60 interventions using JJ, multilink, gfx stents. My success has been 99% at this point. The surgeons at my institution are aggressive with the radial artery as a conduit for CABG. They have inspected the radial artery upon harvesting and they have had little problem in using the vessel as a conduit if necessary. We at this point however, do not have long term patency data. We have noticed, however, that non-invasive testing of the radial artery following angiography on the same day has had poor results. We are currently starting a study looking at non-invasive parameters pre and post transradial catheterization. Are you familiar of any other such studies??

Gary H. Friedman / fabasj7@mcione.com
I have read about the use of 7F catheters via the radial artery. How safe is it for Asian males and females? Any figures ?
Name Dr. NG SWEE CHOON
Email drngsc@tm.net.my
Answers Dr. Hung (Editorial board, Taiwan), who has the largest experience in transradial PTCA in Chinese patients, answered:

Regarding the question of the use of 7F catheters in transradial catheterization in Asian people, I am sorry to say that we do not have any experience in using 7F catheters among our patients. The question has been send to Dr. Saito in Kamakura, Japan.

Dr. S. Saito (Editorial board, Kamakura, Japan) answered:

Because I am now in Beijing, I will send you a part of data from my manuscript stored in my computer concerning the radial artery diameter in Japanese patients:

We have randomly picked up 250 patients for the measurements of the radial artery diameter and Doppler flow. These measurements were done on the day before or same day with the day of PTCA. The mean radial artery diameter in male patients was 3.1 ± 0.6 mm, and that in female patients was 2.8 ± 0.5 mm. From the calculation of sheath sizes, the artery of the diameter > 2.9 mm is thought to accept a 8Fr sheath, and the artery of the diameter > 2.4 mm can accept a 7Fr sheath. After getting the information about the data of radial artery flow after PTCA, we think that the chances of severe flow reduction of the radial artery after PTCA were statistically low when a 8Fr sheath was inserted into the artery > 3.5 mm, a 7Fr sheath into the artery > 3.0 mm and a 6Fr sheath into the artery > 2.6 mm in diameter. The chance of severe flow reduction of the radial artery will be 12.5%, if the sheaths of the outer diameter > the above values are inserted into the radial artery, whereas it will be 3.3%(p=0.024).