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High-Resolution 16-MDCT Evaluation of Radial Artery for Potential Use as Coronary Artery Bypass Graft: A Feasibility Study

Gudrun M. Feuchtner1, Alexander Smekal1, Guy J. Friedrich2, Thomas Schachner3, Johannes Bonatti3, Wolfgang Dichtl2, Martin Deutschmann4 and Dieter zur Nedden1

1 Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
2 Department of Cardiology, Medical University Innsbruck, Innsbruck, Austria.
3 Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria.
4 Siemens Medical Solutions Austria, Wien, Austria.



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  		Fig. 1 —Image obtained using volume-rendered technique shows "praying" position used for MDCT examination.

 


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  		Fig. 2A —52-year-old man with severe (grade 3) atherosclerosis. MDCT image obtained using volume-rendering technique (A) and CT angiography image obtained using rotated volume-rendering technique (B) show course of radial artery (RA) and ulnar artery (UA) are well depicted (arrows). Proximal parts (P, arrowhead) of both vessels are severely affected by atherosclerosis (grade 3), and vessel wall appears irregular. Distal carpal (C) course of ulnar artery is less affected, and fourth digital palmar artery (4DPA) is relatively spared from atherosclerosis.

 


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  		Fig. 2B —52-year-old man with severe (grade 3) atherosclerosis. MDCT image obtained using volume-rendering technique (A) and CT angiography image obtained using rotated volume-rendering technique (B) show course of radial artery (RA) and ulnar artery (UA) are well depicted (arrows). Proximal parts (P, arrowhead) of both vessels are severely affected by atherosclerosis (grade 3), and vessel wall appears irregular. Distal carpal (C) course of ulnar artery is less affected, and fourth digital palmar artery (4DPA) is relatively spared from atherosclerosis.

 


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  		Fig. 3A —Two patients evaluated for atherosclerosis. RA = radial artery, UA = ulnar artery. 66-year-old man with no (grade 0) atherosclerosis. CT angiography image obtained using volume-rendering technique shows no atherosclerosis. Vessel walls (arrows) of radial and ulnar arteries are smooth.

 


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  		Fig. 3B —Two patients evaluated for atherosclerosis. RA = radial artery, UA = ulnar artery. 79-year-old man. CT angiography image obtained using volume-rendering technique shows atherosclerosis: calcified plaques in combination with vessel wall irregularity of ulnar artery and distal tortuosity of ulnar artery (arrows). In contrast, radial artery is sharply delineated with smooth margins without apparent atherosclerosis. Volume-rendering technique permits rotation of up to 360° around longitudinal plane and allows optimal visualization of both vessels.

 


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  		Fig. 4A —Two patients evaluated for palmar arch. RA = radial artery. 74-year-old man. CT angiography image obtained using thin-slab maximum-intensity-projection technique shows complete superficial palmar arch (PA) fed by volar branch (ramus volaris, RV) of radial artery. UA = ulnar artery.

 


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  		Fig. 4B —Two patients evaluated for palmar arch. RA = radial artery. 65-year-old man. CT angiography image obtained using thin-slab maximum-intensity-projection technique shows incomplete superficial palmar arch supplied via ulnar artery. AP = arcus palmaris (palmar arch).

 


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  		Fig. 5 —58-year-old man. CT angiography image obtained using thin-slab maximum-intensity-projection technique shows complete superficial palmar arch (arrows) adjacent to metacarpals.

 

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