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Published on: April 1, 2022
[Endoscopic radial artery harvest for coronary artery bypass grafting: applications and histologic assessment]
Sheng Zhao1, Biao Yuan, Xiao-luan Zhu
1Department of Cardiac and Thoracic Surgery, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
Insights
Endoscopic radial artery harvesting for coronary artery bypass grafting (CABG) is safe and effective. This minimally invasive technique leads to infrequent complications and high patient satisfaction, especially regarding cosmetic results.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Vascular Histology
Context:
- Coronary artery bypass grafting (CABG) is a common surgical procedure.
- Traditional radial artery harvesting can lead to complications and suboptimal cosmetic outcomes.
- Endoscopic harvesting offers a potentially less invasive alternative.
Purpose:
- To evaluate the safety and efficacy of endoscopic radial artery harvesting in CABG patients.
- To assess the incidence of complications associated with this technique.
- To histologically examine the radial artery for signs of trauma after endoscopic harvesting.
Summary:
- Eighty-seven patients underwent CABG using endoscopic radial artery harvesting between 2003 and 2008.
- Harvesting time averaged 57.6 minutes, with conduit lengths of 15-20 cm.
- Histological analysis showed no significant differences between endoscopic and conventional harvesting methods.
Impact:
- Endoscopic radial artery harvesting is associated with infrequent complications.
- The procedure demonstrates excellent patient satisfaction, particularly concerning cosmetic appearance.
- This technique represents a safe and viable option for CABG conduit procurement.
Objective:
To observe the influence of endoscopic radial artery harvesting techniques on the prevalence of complications after coronary artery bypass grafting, and to assess the potential trauma to the radial artery through the histological changes.
Methods:
From August 2003 to June 2008, 87 patients undergoing CABG had radial artery harvested by endoscopic harvesting system. About 4 mm proximal and distal radial artery end segment of 10 patients undergoing endoscopic and conventional harvesting were examined with light and electro-microscope.
Results:
The endoscopic harvest time was 42 to 98 min, with a mean of (57.6 +/- 17.3) min. The harvested conduit length was 15 to 20 cm, with a mean of (17.5 +/- 1.6) cm. Objective dorsal thenar numbness remained in 7 patients, none complained of forearm numbness at 3-month follow-up. The result of light and electro-microscope had no differences in the intima, media, or adventitia between endoscopically and conventionally obtained radial artery segments.
Conclusion:
The use of endoscopic radial artery harvesting in coronary artery bypass grafting can be performed safely with infrequent complications. This method results in excellent patient satisfaction, particularly regarding the cosmetic outcome.
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Pre-Procedural Preparation