Related Experiment Video
Updated: Jun 21, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Reevaluation of two techniques of harvesting the skeletonized internal mammary artery
A A Peivandi1, E Weigang, N Kayhan
1Department of Cardiothoracic and Vascular Surgery, Uniklinik Mainz, Mainz, Germany. peivandi@uni-mainz.de
Background:
Selective skeletonization of the internal mammary artery (IMA) without adjacent vasculo-muscular structures reduces trauma to the chest wall, results in elongated grafts, makes ideal graft positioning possible, and eliminates the need to implant a dissected or hypoplastic graft with direct visual control of the vessel. We compared two techniques of skeletonizing the IMA in a prospective randomized trial.
Methods:
51 IMAs were randomly harvested and divided into two groups according to the technique of skeletonization. In group I (n = 31), IMAs were harvested in a skeletonized fashion with the Harmonic Ultrasonic scalpel, and in group II (n = 20) using scissors and hemostatic clips. We compared arterial wall histology, harvesting time, spasm frequency, and the use of hemostatic clips between the two groups.
Results:
There were no significant morphological differences in the arterial wall in the two groups. Use of an ultrasonically-activated scalpel reduced the IMA's harvesting time (p < 0.001), the frequency of spasm (p = 0.01), and the use of hemostatic clips (p < 0.001).
Conclusions:
Ultrasonic harvesting of a skeletonized IMA is a non-traumatic preparatory technique that reduces the costs of surgical clips and that can be performed safely and quickly.
