Outcome assessment of hand function after radial artery harvesting for coronary artery bypass

Allen, Robert H.; Szabo, Robert M.; Chen, James L.

doi:10.1016/j.jhsa.2004.04.013

Cited by 10 publications

(5 citation statements)

References 46 publications

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“…The reason behind the successful and extensive term benefits of Radial artery harvest is that its distal end is subcutaneous, its diameter is large and its pulse can be sensed without any problem, which was useful for both distal and proximal anastomosis [10]. The length of radial artery was good which gives an easy option for harvesting [11], Leg wound has higher rate of infection as compared to forearm and moreover it has neurological complications [12]. The significance of radial artery harvesting was increased by the presence of calcium channel blockers which helps and protects the graft from arterial contraction [13].…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute

Albkhoor¹,

Hyasat²,

Altaani³

et al. 2021

PBMJ

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Coronary artery stenosis bypass by using radial artery is good techniques which have longer outcomes. In coronary artery bypass grafting (CABG) the radial artery has several advantages. The radial artery has a thick muscular wall which is more susceptible to contraction from the competitive flow. As compared to the open harvesting technique endoscopic harvest of the radial artery has long lasting cosmetic results it also reduces the post-operative complications. The purpose of the study is to compare the two harvesting techniques and compare the short term and long term results related to intra-operative and post-operative outcomes Methods: This is retrospective study (In Queen Alia Heart Institute, Amman ,Jordan) to compare endoscopic radial artery technique versus open technique by reviewing patients files through a period between June 2013 and June 2018. Total 50 patients of CABG surgery was selected they were divided into two groups. Group A includes endoscopic radial harvest (n= 10) and Group B includes open harvest (n=40). Data was collected on predesigned Performa. Data were entered and analyze through IBM SPSS 22.0 Results: There was insignificant dissimilarity between the pre-operative outcomes between groups. The Post-operative outcomes were almost same in both groups except hand numbness (P-value<0.005). The comparison of intraoperative outcomes like harvest time between both groups indicate that the mean harvest time in group A was shorter than group B (39.20 + 3.73 Vs 51.90 + 2.09, P-value=0.000). The operative time in group A was higher than the group B (306.0 + 11.6 Vs 278 + 4.25 p-value=0.00). The hospital stays in both groups were insignificantly different (p = 0.09) Conclusions: Endoscopic radial artery harvest is best suited technique for CABG surgery as it significantly decreases the harvest time as well as hospital stay. It is also proven that it is safer, less painful and better wound appearance technique with exceptional outcomes based on positive surgical experience.

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Section: Resultsmentioning

confidence: 99%

Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute

Albkhoor¹,

Hyasat²,

Altaani³

et al. 2021

PBMJ

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“…These series report long-term sensory neuropathies after harvesting radial arteries for coronary artery bypasses without any significant motor symptoms. 8 , 12 These events are also well documented in patients with Arterio-Venous (AV) fistulas causing ischemic steal syndrome. Steal syndrome develops in 2%–20% of patients with AV fistulas and presents with paresthesia, pain, hand stiffness and pallor, and diminished sensation on physical examination.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of our patient, he underwent preoperative screening utilizing the Allen 11 , 12 bedside exam and the procedure was uncomplicated with a single needle pass under ultrasound guidance. We believe that during the cannulation process, there was a traumatic dissection flap that remained stented while the arterial cannula was in place.…”

Section: Discussionmentioning

confidence: 99%

Radial neuropathy following arterial line removal: A rare complication from a routine ICU procedure

Khalifeh

Khashab

Huffner

et al. 2018

SAGE Open Medical Case Reports

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Radial artery thrombosis is a rare complication of cannulation. There are no reported cases of acute thrombosis and severe acute neuropathy in the setting of cannula discontinuation. We report a case of acute radial nerve mono-neuropathy following thrombosis after radial arterial line removal. The thrombus was immediately evident on exam and diagnostic imaging after cannula discontinuation. The patient was consented and promptly taken to OR for immediate repair. Mild radial neuropathy persisted despite immediate repair. Immediate recognition of signs and symptoms is essential for diagnosis and management, especially in the high-risk population.

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“…Radial artery harvest is relatively easy compared to other arterial conduits since its distal end is subcutaneous, and its pulsation can be felt easily; additionally, it has a large diameter, which facilitates both proximal and distal anastomosis [13]. Moreover, the radial artery has a satisfactory length [14], the forearm wound is less prone to infection compared to the leg wound, and the neurological complications are less frequent [15,16]. The availability of calcium channel blockers that protect the graft from arterial spasm increased the importance of radial artery harvesting and potentiated its role as one of the vital arterial grafts [17].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic versus open harvesting of radial artery for CABG

Fouly

2020

Cardiothorac Surg

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Background: Endoscopic harvest of the radial artery avoids long forearm incisions and has better cosmesis compared to the open technique. The objective of this study was to compare the short-term results and woundrelated complications of endoscopic radial artery harvest versus open technique. Results: From 2013 to 2017, 800 patients had coronary artery bypass grafting; 88 patients of them had radial artery harvesting (11%). Two groups were included in the study according to the surgeon preference, endoscopic radial harvest (group 1, n = 30; 3.75% of total CABG patients) and open harvest (group 2, n = 58; 7.25% of total CABG patients). Group 1 had more males (25 (83.33%) vs. 35 (60.34%); p = 0.028). There was no difference in the preoperative comorbidities between both groups. The duration of the harvest was significantly longer in group 1 (median 40 min ranges from 38 to 42 min vs. 49 min ranges from 47 to 52 min in groups 1 and 2, respectively; p < 0.001). The operative time was longer in group 1 (median 302.5 min ranges from 295 to 310 min vs. 277 min ranges from 273 to 280 min in groups 1 and 2, respectively; p < 0.001). The hospital stay in the endoscopic radial artery harvest group was significantly shorter than that of open technique (median 7 days ranges from 6 to 7 days vs. 7.5 days ranges from 7 to 9 days; p < 0.001). There was no significant difference in the postoperative complications between both groups. One case (3.3%) was transformed from the endoscopic to open technique due to uncontrolled bleeding. Endoscopic technique was associated with more patients presenting with hand numbness (6 cases; 20% versus 3 cases 5.2%) and radial nerve injury (2 cases; 6.6% versus none), while open technique showed more cases of local hematoma (8 cases; 13.8% versus 1 case; 3.3%) and wound infection (6 cases; 10.34% versus none); p > 0.05. Conclusion: Endoscopic radial artery harvest is associated with shorter harvest time and shorter hospital stay. Endoscopic radial artery harvest is a safe technique with good short-term outcomes. Longer follow-up is recommended.

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Outcome assessment of hand function after radial artery harvesting for coronary artery bypass

Cited by 10 publications

References 46 publications

Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute

Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute

Radial neuropathy following arterial line removal: A rare complication from a routine ICU procedure

Endoscopic versus open harvesting of radial artery for CABG

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