Multiple Radial Artery Plaques
A 73-year-old man with recurrent chest pain was referred to our institution and admitted with a diagnosis of unstable angina. He had a history of angina for 2 months, and his risk factors for coronary artery disease included hypertension, hypercholesterolemia, and diabetes. Coronary angiography taken via the left radial artery revealed 3-vessel disease, 90% stenosis of the proximal left ascending artery, 75% stenosis of the proximal right coronary artery, and 100% occlusion of the left circumflex artery. The left anterior descending artery was thought to be the culprit lesion and was successfully revascularized by primary implantation of a 3.5×18 mm stent. After the coronary procedure, an intravascular ultrasound study of the left radial artery showed multiple radial artery plaques (Figure).
Thus far, our group has performed intravascular ultrasound studies of the radial arteries in about 300 cases. Rarely have we found prominent and multiple radial artery plaques. If this patient is to be considered for coronary bypass surgery, the radial artery should not be used for the bypass graft.