Radial artery harvesting with harmonic scalpel: fully no-touch technique

The radial artery has been used for decades as an alternative to other arterial bypass graft conduits. Positive long-term patency results and survival benefits have led to an increase in its popularity. The emerging evidence of the need for total arterial myocardial revascularization unleashes the potential of the radial artery as a versatile arterial conduit capable of reaching all coronary targets in a lot of different configurations. In addition, a radial artery graft has proven benefits in terms of graft patency compared with a saphenous venous graft. In this context, multiple randomized clinical trials have repeatedly proven the improved clinical outcomes of radial artery grafts based on 10 years of follow-up; the radial artery graft has also been shown to be a suitable arterial conduit in up to 90% of coronary artery bypass grafting cases. Despite the scientific evidence regarding the benefits of the radial artery graft, most surgeons are still reluctant to use the radial artery in coronary artery bypass graft procedures. Consequently, surgical residents risk not developing solid surgical skills for utilization of the radial artery graft. Safe, easy-to-learn techniques are needed to speed up the learning curve and at the same time lower the complications. In this context, a fully no-touch technique for harvesting the radial artery using a harmonic scalpel can be the right way to introduce young surgeons to this basic but paramount skill.