Skeletonized harvesting improves the early-term and mid-term perfect patency of a radial artery graft

Miyagi, Naoto; Oshima, N; Shirai, Toshizumi; Sunamori, Makoto

doi:10.1007/s11748-006-0038-x

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Additionally, the skeletonization technique insures better response of the LITA conduits to the intraluminal vasodilators [46]. According to Miyagi et al [48], Amano et al [25] and Ali et al [26], skeletonization of the RA is superior to the pedicled technique in terms of patency rates, ranging from 96.5% to 100% vs. 77.5% to 86.7%, respectively. However, there are also disadvantages, such as irreversible injury to the RA or spasms provoked by electrocautery, depending both on the surgical material and experience [27].…”

Section: Ra Harvesting Techniquementioning

confidence: 99%

Radial artery as graft for coronary artery bypass surgery: Advantages and disadvantages for its usage focused on structural and biological characteristics

Baikoussis

Papakonstantinou

Apostolakis

2014

Journal of Cardiology

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Radial artery (RA) is the most popular arterial graft after the left internal thoracic artery in both low- and high-risk patients undergoing coronary artery bypass grafting. Various arterial grafts such as the right internal thoracic artery, the right gastroepiploic artery, and the inferior epigastric artery have also gained ground over the past 30 years because of the intimal hyperplasia and atherosclerosis of the saphenous vein leading to late graft occlusion. In this review article we would like to present the utility of the RA as a graft, focused mainly on its structural and biological characteristics.

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Section: Ra Harvesting Techniquementioning

confidence: 99%

Radial artery as graft for coronary artery bypass surgery: Advantages and disadvantages for its usage focused on structural and biological characteristics

Baikoussis

Papakonstantinou

Apostolakis

2014

Journal of Cardiology

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“…Different approaches have been proposed and are currently used for auto-arterial conduit preparation including various dissection techniques and different options of the pharmacological antispasmodic protocol. For example, extrafascial harvesting technique, instead of skeletonization, significantly decreases the frequency of arterial spasm [8,9]. Treatment of the arterial conduits with calcium antagonists, nitrates, α-adrenoblockers, their combinations, and calmodulin also prevents arterial spasm [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Functional Recovery of Radial Artery Conduit for Coronary Artery Bypass Grafting

Ripp

Кондратьева

Афанасьев

et al. 2018

Sibirskij medicinskij žurnal

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The authors have studied the effect of lercanidipine on the functional status of radial artery used as conduit for CABG in patients with coronary artery stenosis. Endothelium-dependent vasodilation (ΔD) was evaluated preoperatively by using duplex ultrasound. Patients were divided into groups I and II with ΔD≥8% and ΔD<8%, respectively. Group II was divided into groups IIA (lercanidipine) and IIB (control). Mechanical force of isolated arterial segments was initially lower in group I. Preoperative treatment with lercanidipine (2.5–5 mg/kg for 5–7 days) led to a significant increase in endothelium-dependent vasodilation and decrease in tone of isolated arterial segments. Preoperative treatment with lercanidipine effectively preserved dilatational properties of arterial conduit.

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“…Harvesting as a traditional “non-skeletonized” graft including an accompanying vein and surrounding connective tissue minimizes surgical trauma, thus was considered to reduce tendency to spasm [ 7 ]. However, recent studies reported the other harvesting technique “skeletonization” reduced spasm and improved RA graft patency [ 8 , 9 , 10 ]. These conflicting reports prompted us to examine the effect of the different harvesting technique on luminal diameter of the RA graft.…”

Section: Introductionmentioning

confidence: 99%

Change of luminal diameter of skeletonized and non-skeletonized radial artery graft at early and late postoperative period

et al. 2015

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The radial artery is increasingly used as a second arterial conduit for myocardial revascularization. However, the radial artery is susceptible to vasospasm, which is thought to be the principal cause of graft failure. The radial artery is harvested as a skeletonized or a non-skeletonized graft, but the effect of different harvesting technique remains unknown. In this study, we compared the early- and mid-term angiographic findings to elucidate its influence on the graft luminal diameter. We harvested 39 radial arteries either as a skeletonized (n = 18) or a non-skeletonized graft (n = 21) using an ultrasonic scalpel. We constructed a composite straight graft by combining a right internal thoracic artery and a radial artery. All the radial artery grafts were sequentially anastomosed to coronary arteries. We measured the diameters of the radial arteries before the operation, within 1 month and 1 year after the operation. At early postoperative period, graft diameter was significantly larger in skeletonized grafts. Graft diameter at the point before the first and the second anastomosis was similar in skeletonized grafts, although that was significantly smaller before the second anastomosis in non-skeletonized grafts. However, 1 year after the operation, the graft diameter was comparable and equally reduced after the first anastomosis in both groups. Skeletonization with an ultrasonic scalpel increases the luminal diameter of the radial artery graft at early postoperative period, which, however, reduces possibly as adaptation to graft flow 1 year after the operation.

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Skeletonized harvesting improves the early-term and mid-term perfect patency of a radial artery graft

Abstract: The early- and mid-term patency of RA grafts was excellent, and skeletonized harvesting improved the perfect patency rates at both time points.

Cited by 7 publications

References 18 publications

Radial artery as graft for coronary artery bypass surgery: Advantages and disadvantages for its usage focused on structural and biological characteristics

Radial artery as graft for coronary artery bypass surgery: Advantages and disadvantages for its usage focused on structural and biological characteristics

Functional Recovery of Radial Artery Conduit for Coronary Artery Bypass Grafting

Change of luminal diameter of skeletonized and non-skeletonized radial artery graft at early and late postoperative period

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