Purpose of review: Multiple arterial grafting has been proposed to improve outcomes after coronary bypass surgery. We sought to define the emerging role of the radial artery as an alternative second arterial graft.
Recent findings: Despite significant evidence suggesting superiority of bilateral internal thoracic artery grafting, utilization in current clinical practice remains low due to concerns about sternal wound infection and conduit length. Recent clinical trials have started to clarify the role of the radial artery in coronary surgery. This conduit provides superior patency to saphenous vein grafts in the setting of high-grade stenosis regardless of the target territory and with minimal harvest site complications.
Summary: The radial artery is a versatile conduit that provides clinical benefit in a large variety of patients undergoing coronary bypass surgery. Outcomes from ongoing longitudinal clinical trials will further clarify optimal conduit selection strategies.