Harvesting techniques affect the integrity of the radial artery: an electron microscopic evaluation

Four methods of radial artery harvesting were evaluated with transmission electron microscopy and tissue lipid peroxidation to determine the degree of damage to the artery.

Radial artery samples from 4 groups of patients (10 samples from each group) who underwent coronary artery surgery were evaluated. In groups I and II, radial arteries were stored in a solution containing 100 mL patients' own heparinized oxygenated blood and 5 mg nitroglycerine. The grafts were distended in group II. In groups III and IV, side branches of the grafts were occluded and left in situ until the coronary anastomosis. In group III, the distal end of the graft was also occluded, while in group IV, both ends were open.

The least degree of endothelial damage and disruption of arterial wall integrity were in group IV according to electron microscopic evaluation. The grafts in group III were relatively in good condition compared to groups I and II. Tissue lipid peroxidation was also lowest in group IV. Tissue lipid peroxide levels correlated with ischemic preservation period of the radial artery (r = 0.426). Total semiquantitative transmission electron microscopic scores of the radial artery samples correlated with the lipid peroxide levels (r = 0.581) and ischemia times (r = 0.734).

All arterial grafts, including the radial artery that will be used for coronary artery surgery should not be left ischemic during harvesting to prevent endothelial damage. Ischemia of the conduits for coronary artery grafting can be prevented by leaving them in their anatomic position until the distal coronary artery anastomosis.