Radial artery grafts in women: Utilization and results

Background. Despite a known survival benefit with the use of the left internal mammary artery, it is used less frequently in women when compared with men. This study evaluated the hypotheses that the radial artery graft is used less frequently in women compared with men, that the radial artery is smaller in women compared with men, and that the use of the radial artery influences operative mortality and long-term survival in women. Methods. The use of a radial artery graft was evaluated in 2,633 patients who underwent isolated coronary artery bypass. Radial artery size and flow were compared in 207 patients who had intraoperative radial artery diameter and flow measurements. Propensity scoring was utilized to compare short- and long-term outcomes in a matched cohort of 588 women. Results. Of 862 women (33%) who had isolated coronary artery bypass grafting, only 301 (35%) received a radial artery graft versus 44% of men (786 of 1,771, p < 0.001). Radial artery size and flow were significantly less in women. Operative mortality was not different between women with a radial artery graft and women without; however, 5-year survival was significantly better in women with a radial artery graft than in those without. Conclusions. Women received fewer radial artery grafts than men. Radial artery size and flow were significantly less in women than in men. Use of a radial artery graft did not influence operative mortality among women. However, 5-year survival among women who received a radial artery graft was significantly better than among women who did not.