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Intraoperative pressure measurement in radial artery harvest. A tool with additional value?
M Kohonen1, O Teerenhovi, P Taskinen
1Heart Center, Tampere University Hospital, Tampere, Finland. mika.kohonen@sydankeskus.fi
Objectives:
The radial artery is widely used as a graft in coronary artery bypass surgery (CABG). Due to its location and function it should be screened prior to harvesting to avoid ischaemic complications of the hand. In acute situations the Allen test is often the only preoperative screening method available. As has been noted earlier, a negative Allen test does not mean a non-harvestable radial artery. We endeavoured to find out whether intraoperative pressure measurement could be used as a complement while screening the radial artery.
Design:
Ninety patients planned for elective CABG with radial artery as a conduit were examined preoperatively with the Allen test, handheld Doppler and pletysmography of the second and fourth digits. Radial artery pressure was measured intraoperatively. Symptom scale was recorded pre- and postoperatively.
Results:
There were ten patients with a positive Allen test. The intraoperative index of radial artery pressures was 0.868 in the Allen positive group and 0.885 in the Allen negative group with no statistically significant difference (P value .68). Tolerance of exercise and cold was significantly impaired postoperatively, P values .002 and .001 respectively. No ischaemic complications occurred.
Conclusions:
Intraoperative pressure measurement can be used when screening radial arteries are to be harvested and no metric preoperative screening methods are available.
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