The Arterial Grafts for Coronary Artery Bypass Grafting: Review of Current Knowledge in Regard of the Radial Artery and the Right Gastroepiploic Artery

The benefits of using arterial grafts in coronary artery bypass grafting (CABG) have been elucidated in previous investigations. Alternative arterial grafts such as radial artery (RA) and right gastroepiploic artery (RGEA) have been used widely for CABG with increasing importance. Med-Line (1986-2010) was searched using the subsequent keyword arterial graft, CABG, RA and GEA. Overall, a total of 82 observational and comparison studies were considered relevant to this review and were summarized. This review provides a summary of the outcomes of RA and/or GEA arterial grafts regarding morbidity, mortality, patency rates, technical features and certain characteristics of the considered arterial conduits. This review article further supports the utility of the RA when used as either a composite or aortocoronary graft which results in improved results. Although some investigations showed acceptable results justify its use in clinical settings, there is still much concern about using the GEA in CABG. Right GEA, as an arterial graft, can be used as an in situ graft or a free graft. Introduction: Coronary artery bypass graft (CABG) with arterial graft is increasingly used for myocardial revascularization (1-4). At the present time several favorable outcomes of CABG with various types of arterial grafts has been shown (10-12); however, different investigations in recent years reveled controversies in this regard (13-17). It should be pointed out that several studies revealed that the postoperative results of CABG with various types of arterial grafts resulted in improved outcomes than saphenous vein grafts (SVGs) regarding mortality, patency rate, and relief of symptoms (18-24). In view of the foregoing circumstances we decided to summarize the current investigations concerning the different aspects of arterial grafts, using radial artery (RA). Advantages and disadvantages of using gastroepiploic artery (GEA) graft for CABG was also reviewed in this article. Methods: Med-Line (1986-2010) was searched using the subsequent keyword arterial graft, CABG, RA and GEA. Searches were not restricted by language or study format. A total of 122 studies were identified. Reference lists of the identified papers were also screened to recognize additional relevant publications. Overall, a total of 82 observational and comparison studies were considered relevant to this review and were summarized. Outcomes of RA and GEA grafts in CABG were focused