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Should the internal thoracic artery be skeletonized?

Thanos Athanasiou1, Mary-Clare Crossman, George Asimakopoulos

  • 1The National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Department of Cardiothoracic Surgery, St Mary's Hospital, London, United Kingdom. tathan5253@aol.com

The Annals of Thoracic Surgery
|June 3, 2004
PubMed

Insights

Skeletonized internal thoracic artery (SKT-ITA) harvesting offers potential benefits in cardiac surgery. This review examines evidence on SKT-ITA effects on graft patency and clinical outcomes compared to traditional pedicle harvesting.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • The internal thoracic artery is a crucial graft in coronary artery bypass grafting.
  • Traditionally harvested as a pedicle, the skeletonization technique is increasingly adopted.
  • Evidence on the impact of skeletonization on graft quality and patient outcomes requires systematic evaluation.

Purpose of the Study:

  • To systematically review and analyze existing clinical studies on skeletonized internal thoracic artery (SKT-ITA) use.
  • To assess the effects of skeletonization on sternal blood supply, vessel wall integrity, and graft blood flow.
  • To evaluate the impact of SKT-ITA on postoperative graft patency and overall clinical outcomes.

Main Methods:

  • Systematic review of clinical studies reporting on SKT-ITA.
  • Analysis of data concerning sternal perfusion, vessel damage, and blood flow.
  • Evaluation of graft patency rates and clinical outcomes in SKT-ITA versus pedicle grafts.

Main Results:

  • Skeletonization may preserve sternal blood supply and minimize vessel wall trauma.
  • Studies suggest comparable or improved graft patency with SKT-ITA.
  • Clinical outcomes associated with SKT-ITA require further comprehensive analysis.

Conclusions:

  • Skeletonized internal thoracic artery harvesting is a viable alternative to pedicle harvesting.
  • Further research is needed to fully elucidate the long-term benefits and potential risks of SKT-ITA.
  • The technique's impact on sternal healing and graft performance warrants continued investigation.

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