Related Experiment Video
Updated: Jun 25, 2026
Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
Late presentation digital ischemia after radial artery harvest for coronary artery bypass
Matthew Liava'a1, Sanjay Theodore, Timothy Wagner
1Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Victoria, Australia. mattliavaa@gmail.com
Insights
Radial artery grafts are common for coronary artery bypass, but harvesting can cause rare digital ischemia. Consider comorbidities like collagen vascular disease as contraindications for radial artery harvest.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Grafting Procedures
Background:
- The radial artery is a frequently utilized graft in coronary artery bypass surgery.
- While harvesting morbidity is infrequent, complications such as digital ischemia can arise post-operatively.
Observation:
- This report details a case of delayed digital ischemia occurring after radial artery harvesting for coronary artery bypass grafting.
- The patient's preoperative assessment did not indicate a risk for this complication.
Findings:
- Digital ischemia can manifest late after radial artery harvest, even with normal preoperative vascular assessments.
- The presence of comorbidities, specifically collagen vascular disease combined with atherosclerotic peripheral vascular disease, significantly increases the risk.
Implications:
- Careful preoperative evaluation for comorbidities is crucial before radial artery harvest.
- Collagen vascular disease and peripheral artery disease should be considered relative contraindications for radial artery harvesting.
- This case highlights the importance of considering the cumulative risk factors in graft selection for coronary artery bypass surgery.
Abstract:
The radial artery is increasingly being used as a coronary artery bypass graft. Morbidity from harvesting is rare, yet it does occur. We present a case of digital ischemia presenting late after surgery and suggest that although preoperative assessment may be normal, comorbidities such as collagen vascular disease in conjunction with atherosclerotic peripheral vascular disease should be carefully considered as a contraindication to radial artery harvest.
Related Concept Videos
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation