Could use of the internal thoracic artery be avoided under certain conditions?

Yes: While the use of the internal thoracic artery could be avoided - the longevity of graft survival from the use of this artery is superior to the longevity of reverse savenous vein grafts. Also, radial arteries and the gastroeploic arteries can be used in selective circumstances for cornary bypass grafts as well.

Yes: Understand: use of the lita has been shown in many studies to improve survival when used as a conduit in CABG surgery. That said, if flow is poor as measured at the time of surgery of the there is a lesion in the left subclavian proximal to the origin of the lita, it should not be used.