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Updated: Oct 2, 2026
Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
[Radial artery for coronary artery bypass grafting: operative techniques and early results]
1Department of Cardiothoracic Surgery, He'nan Provincial People's Hospital, Zhengzhou 450003, China.
Insights
Radial artery (RA) grafts are safe and effective for coronary artery bypass grafting (CABG), yielding good results. A no-touch harvesting technique and calcium-channel blockers are key to graft patency.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Cardiac Procedures
Context:
- Coronary artery bypass grafting (CABG) is a common surgical procedure.
- The radial artery (RA) has emerged as a potential conduit for CABG.
- Evaluating the safety and efficacy of RA utilization in CABG is crucial.
Purpose:
- To review the experience of using the radial artery (RA) for coronary artery bypass grafting (CABG).
- To assess the outcomes and safety of RA grafts in CABG patients.
- To identify essential techniques for successful RA utilization in CABG.
Summary:
- A total of 71 patients underwent CABG using radial artery grafts between June 1997 and December 1999.
- A 'no-touch' harvesting technique and intraluminal papaverine solution were employed.
- Postoperative outcomes included a 1.4% operative mortality, with no graft failures, compartment syndrome, or hand ischemia.
Impact:
- The radial artery (RA) is a safe and effective conduit for coronary artery bypass grafting (CABG).
- The 'no-touch' harvesting technique and calcium-channel blocker use are vital for optimal RA graft function.
- This study supports the routine use of RA in CABG procedures, contributing to improved patient outcomes.
Objective:
To review the experience coronary artery bypass grafting (CABG) with the radial artery (RA) performed from June 1997 to December 1999.
Methods:
A total of 71 patients received CABG in whom the performance of the radial and ulnar arteries were checked preoperatively with the modified Allen's test. A curvilinear skin incision was made from 3 cm distal to the cubital fossa to 2 cm before the proximal crease at the wrist. The RA was mobilized together with its satellite veins and surrounding fat tissues. Small branches were divided between titanium clips. Direct touching on the RA trunk was totally avoided and use of diathermy was minimized. A 1% papaverine solution of heparinized Ringer's was applied intraluminally into the free RA graft before it was stored in the same solution for later use. Seventy-two RAs were harvested and 79 distal anastomoses were made mostly to the posterior descending branches and the circumflex marginal branches. All the proximal anastomoses were directed to the aorta. Calcium channel blockers were routinely used for a period of 6 months postoperatively.
Results:
There was 1 death for an operative mortality of 1.4%. The death was not caused by failure of RA graft. There was no compartment syndrome or hand ischemia. No perioperative myocardial infarction was observed.
Conclusions:
It is easy and safe to use the RA for CABG by which good results can be achieved. A'no-touch' harvesting technique and use of calcium-channel blockers are essential to the functioning of this conduit.
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