Limb performance and patient satisfaction after radial artery harvesting: endoscopic versus open techniques

Medalion, Benjamin; Fuks, Avraham; Sharoni, Erez; Stamler, Alon; Snir, Eitan; Vidne, Bernardo A.; Porat, Eyal E.

doi:10.1007/s00464-008-9777-3

Cited by 13 publications

(12 citation statements)

References 18 publications

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“…Other retrospective observational studies, comparing endoscopic and open technique also showed reduction of wound healing and neurological complications, in favor of ERAH. Moreover, significantly reduced impairment in work and regular daily activities (0% vs.12%) and postoperative pain (0% vs. 8%) was observed 21 . Avoidance of long forearm skin incision in ERAH minimizes the risk of the LACN injury in contrast to ORAH.…”

Section: Discussionmentioning

confidence: 86%

Endoscopic radial artery harvesting for coronary artery bypass grafting. A single center evolving experience

Šimek¹,

Marcián²,

Gwozdziewicz³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aim. We sought to evaluate our experience with endoscopic radial artery harvesting for coronary artery bypass grafting (CABG). Methods. From October 2005 to June 2010, 50 patients who underwent endoscopic radial artery harvesting for an elective CABG were prospectively assessed for harvesting characteristics, complications, postoperative and mid-term outcomes.Results. There were 34 (68%) males and 16 (32%) females, average age 60.8±9.2 years. All but two RA grafts (96%) were successfully harvested endoscopically. Mean harvesting time was 46.2±9.3 min and mean length of harvested grafts was 23.4±2.2 cm. In the post-operative period there were no wound-healing complications; residual forearm edema was recorded in 6 patients (12%) and peripheral neuropathy in 4 patients (8%). At 3 months after the surgery, peripheral neuropathy and residual edema persisted in 2 patients (4%). A significant drop of overall harvesting time (56.2± 18.6 vs. 38.6±8.6 min, P<0.05) and forearm ischemia time (41.8±12.7 vs. 24.2±3.2 min, P<0.01) was found between first and last ten cases in the group. Conclusion. Endoscopic radial artery harvesting was associated with low risk of post-harvesting complications and most of these disappeared within a 3 months follow-up. However, there was a significant learning curve.

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Section: Discussionmentioning

confidence: 86%

Endoscopic radial artery harvesting for coronary artery bypass grafting. A single center evolving experience

Šimek¹,

Marcián²,

Gwozdziewicz³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…This study compared radial artery harvest to vein harvest. There has also been a quality of life study comparing ERAH versus ORAH which used a short questionnaire devised by Medalion as outcome [24]. The questionnaire used in the RAPCO study seems more precise than the four questions used by Medalion, which is why it has been chosen for this trial.…”

Section: Methods and Designmentioning

confidence: 99%

“…The published studies differ in how the investigators examine the extent of neurological deficits. Most use non-specific neurological examinations and others only rely on questionnaires [24]. The most specific examination procedure seems to be used by Bleiziffer et al, who assessed the muscle strength, deep tendon reflexes, temperature, pain, and touch sensation [18].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic versus open radial artery harvest and mammario-radial versus aorto-radial grafting in patients undergoing coronary artery bypass surgery: protocol for the 2 × 2 factorial designed randomised NEO trial

Carranza

Ballegaard

Werner

et al. 2014

Trials

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BackgroundCoronary artery bypass grafting using the radial artery has, since the 1990s, gone through a revival. Observational studies have indicated better long-term patency when using radial arteries. Therefore, radial artery might be preferred especially in younger patients where long time patency is important. During the last 10 years different endoscopic techniques to harvest the radial artery have evolved. Endoscopic radial artery harvest only requires a small incision near the wrist in contrast to open harvest, which requires an incision from the elbow to the wrist. However, it is unknown whether the endoscopic technique results in fewer complications or a graft patency comparable to open harvest. When the radial artery has been harvested, there are two ways to use the radial artery as a graft. One way is sewing it onto the aorta and another is sewing it onto the mammary artery. It is unknown which technique is the superior revascularisation technique.Methods/DesignThe NEO Trial is a randomised clinical trial with a 2 × 2 factorial design. We plan to randomise 300 participants into four intervention groups: (1) mammario-radial endoscopic group; (2) aorto-radial endoscopic group; (3) mammario-radial open surgery group; and (4) aorto-radial open surgery group.The hand function will be assessed by a questionnaire, a clinical examination, the change in cutaneous sensibility, and the measurement of both sensory and motor nerve conduction velocity at 3 months postoperatively. All the postoperative complications will be registered, and we will evaluate muscular function, scar appearance, vascular supply to the hand, and the graft patency including the patency of the central radial artery anastomosis. A patency evaluation by multi-slice computer tomography will be done at one year postoperatively.We expect the nerve conduction studies and the standardised neurological examinations to be able to discriminate differences in hand function comparing endoscopic to open harvest of the radial artery. The trial also aims to show if there is any patency difference between mammario-radial compared to aorto-radial revascularisation techniques but this objective is exploratory.Trial registrationClinicalTrials.gov identifier: NCT01848886.Danish Ethics committee number: H-3-2012-116.Danish Data Protection Agency: 2007-58-0015/jr.n:30–0838.

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“…Minimally invasive techniques have been proposed by many authors using endoscopic devices with superior outcomes. However, this approach is time consuming, needs expensive instrumentation, and has a significant learning curve 8‐11 …”

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confidence: 99%

“…However, this approach is time consuming, needs expensive instrumentation, and has a significant learning curve. [8][9][10][11] We present a tunneling radial artery harvesting technique under direct vision that is safe, less invasive compared to standard open technique, and cost-effective compared to endoscopic techniques. , 40 consecutive patients scheduled for coronary artery bypass grafting were randomly divided into two groups.…”

mentioning

confidence: 99%

Open Versus Tunneling Radial Artery Harvest for Coronary Artery Grafting

Voucharas

Bisbos

Moustakidis

et al. 2010

Journal of Cardiac Surgery

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We present a less traumatic surgical technique for harvesting the radial artery as a coronary artery bypass graft that does not require any special equipment or skills. We prospectively randomized 40 patients undergoing coronary artery bypass grafting with the radial artery into two groups on the basis of harvest techniques: tunneling excision and conventional open method. The less-invasive tunneling technique is safe, easily applicable, and preferred by patients because of the superior cosmetic result.

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Limb performance and patient satisfaction after radial artery harvesting: endoscopic versus open techniques

Abstract: After a mean of 9.8 months after surgery, patients reports good overall upper-limb function. However, more patients in the open technique had significant disabilities and dissatisfaction.

Cited by 13 publications

References 18 publications

Endoscopic radial artery harvesting for coronary artery bypass grafting. A single center evolving experience

Endoscopic radial artery harvesting for coronary artery bypass grafting. A single center evolving experience

Endoscopic versus open radial artery harvest and mammario-radial versus aorto-radial grafting in patients undergoing coronary artery bypass surgery: protocol for the 2 × 2 factorial designed randomised NEO trial

Open Versus Tunneling Radial Artery Harvest for Coronary Artery Grafting

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