Radial Artery Harvest Using Endoscopic Techniques

Authors

  • Roxanne V. Newman
  • W. Greg Lammle

DOI:

https://doi.org/10.1532/hsf.1072

Abstract

Background: Endoscopic vessel harvest for coronary artery bypass conduit has become a routine procedure. With the advancement of endoscopic equipment, radial arteries can be safely harvested with excellent cosmetic results.

Methods: One hundred consecutive patients undergoing coronary artery bypass grafting underwent endoscopic radial artery harvest without complications requiring intervention. The vessel was accessed through a 3-cm long, longitudinal incision performed several millimeters medial to the palpated artery to avoid the lateral antebrachial cutaneous nerve. Commercially available endoscopic retractors, using ultrasonic or direct-current shears, were used to ligate side branches and mobilize the pedicled artery and satellite veins. Ligation was performed with clips at the wrist, endo-loops proximally, and endoshears for transection.

Results: Patient age ranged from 42 to 88 years; 70% of the patients were men, and 26% were diabetic. Left radial arteries were preferentially harvested. All arteries were used and no further conduit was needed because of inadequate length. In 2 patients subcutaneous hematomas formed postoperatively and resolved without exploration. Although some thenar dysthesia was present in 14 patients, no permanent neurovascular injuries occurred. There were no infections, although skin edges did get traumatized from the retractor.

Comment: Radial arteries can be harvested in a reproducible, safe, and efficient manner with less morbidity and better patient satisfaction.

References

Iaco AL, Theodori G, DiGiammarco G, et al. 2001. Radial artery for myocardial revascularization: long-term clinical and angiographic results. Ann Thorac Surg 72:464-9.nTatoulis J, Royse AG, Buxton BF, et al. 2002. The radial artery in coronary artery surgery: a 5-year experience--clinical and angiographic results. Ann Thorac Surg 73:143-8.nAcar C, Jebara V, Portoghese M, et al. 1992. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 54:652-9.nAseed I, Anyanwu AC, Yacoub MH, et al. 2001. Subjective patient outcomes following coronary artery bypass using the radial artery: results of the harvest site complications and quality of life. Eur J Cardiothoracic Surg 20:1141-6.nBhan A, Gupta, V, Choudhary SK, et al. 1999. Radial artery in CABG: could the early results be comparable to internal mammary artery graft? Ann Thorac Surg 67:1631-6.nDenton RA, Trento L, Cohen M, et al. 2001. Radial artery harvesting for coronary artery bypass operations: neurologic complications and their potential mechanism. J Thorac Cardiovasc Surg 121:951-6.n

Published

2005-02-07

How to Cite

Newman, R. V., & Lammle, W. G. (2005). Radial Artery Harvest Using Endoscopic Techniques. The Heart Surgery Forum, 6(6), E194-E195. https://doi.org/10.1532/hsf.1072

Issue

Section

Articles