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Radial artery harvest technique, use and functional outcome
1Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia. alistair.royse@nwhcn.org.au
Summary
Radial artery (RA) harvest is a simple technique with low morbidity. This method preserves hand strength and function, making it a safe option for coronary artery bypass grafting (CABG).
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Surgical Techniques
Background:
- The radial artery (RA) is increasingly used as a conduit in coronary artery bypass grafting (CABG).
- A simple and safe harvest technique for the RA is crucial for its widespread adoption.
Purpose of the Study:
- To present a straightforward technique for harvesting the radial artery (RA).
- To evaluate the morbidity and functional outcomes associated with RA harvest.
Main Methods:
- The described technique involves dividing the neurovascular fascia surrounding the RA, utilizing loose areolar tissue for minimal trauma.
- Topical and intraluminal vasodilators were employed, avoiding systemic vasodilators.
Main Results:
- From 1996 to 1998, 2167 radial arteries (RAs) were harvested for 3105 coronary anastomoses, leading to an 80% RA utilization rate in CABG patients.
- Total arterial revascularization increased to 80%, with composite arterial grafting at 40%.
- Hand strength remained unaffected; morbidity included 0.3% superficial radial nerve sensation loss, 2.1% lateral cutaneous nerve sensation loss, and 20% scar hypersensitivity. Late hand ischemia was rare (two patients).
Conclusions:
- Radial artery (RA) harvest, when performed within the neurovascular plane, is a simple procedure.
- This technique is associated with low patient morbidity and preserves functional outcomes.