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

Background: Only scant information is available on the chronic consequences of radial artery removal for coronary artery bypass surgery on forearm circulation. Methods: 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. Results: 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). Conclusion: 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.