Does radial artery harvesting for coronary revascularization cause neurological injury in the forearm and hand?

Ikizler, Murat; Özkan, Serhat; Dernek, Sadettin; Özdemır, Coşkun; Erdinç, Oğuz Osman; Sevin, Behçet; Özdemir, Gazi; Kural, Tuğrul

doi:10.1016/j.ejcts.2005.06.004

Cited by 21 publications

(23 citation statements)

References 16 publications

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“…The reported incidence of neurologic complications in open harvesting has ranged from 9.5% to 67.7%. [8][9][10][11][12][13][14][15] In our endoscopic harvesting series, objective dorsal thenar numbness in the distribution of the superfi cial radial nerve occurred in 8% of patients. In previous studies, the incidence of neurologic complications after endoscopic harvesting has ranged from 1% to 27.8%.…”

Section: Discussionmentioning

confidence: 69%

“…Furthermore, open harvesting is associated with several problems, particularly neurologic complications. [8][9][10][11][12][13][14][15] In an attempt to improve cosmetic outcomes and reduce the incidence of complications, we began performing endoscopic radial artery harvesting with the VasoView Endoscopic Vessel Harvesting System (Guidant, Santa Clara, CA, USA). Our initial endoscopic harvesting experience and short-term clinical results are described herein.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Radial Artery Harvesting: Patient Satisfaction and Complications

Nishida

Kikuchi

Watanabe

et al. 2008

Asian Cardiovasc Thorac Ann

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Endoscopic radial artery harvesting was recently introduced to reduce the morbidity associated with conventional open harvesting and improve cosmetic outcomes. From January 2004 through December 2006, 25 radial arteries were harvested endoscopically from 25 patients using the VasoView endoscopic system. Bilateral radial arteries were harvested from 6 patients by both the endoscopic and open techniques, and postoperative patient satisfaction was assessed using a visual analogue scale. Mean harvesting time was 61.9 +/- 16.0 min (range, 44-105 min), and mean harvested conduit length was 16.8 +/- 2.0 cm (range, 15-19 cm). Objective dorsal thenar numbness remained in 2 patients (8%); none complained of forearm numbness. All patients expressed marked satisfaction with the endoscopic technique and the small incision. Patient satisfaction was significantly higher with the endoscopic technique than with the open technique (visual analogue scale of 9 vs 5). Postoperative angiography revealed occlusion of a graft that had been anastomosed to a small diagonal branch. The overall graft patency was 96.6%. Endoscopic radial artery harvesting can be performed safely with infrequent complications. This method results in excellent patient satisfaction, particularly regarding the cosmetic outcome.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Endoscopic Radial Artery Harvesting: Patient Satisfaction and Complications

Nishida

Kikuchi

Watanabe

et al. 2008

Asian Cardiovasc Thorac Ann

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“…However, doubts exist over the deleterious effects on the patient of sacrificing the radial artery while few studies have specifically addressed this issue. 3,8,14 In routine clinical practice, some professionals contraindicate RFF in some situations, wary of sacrificing the radial artery and compromising blood circulation to the hand, even though the arterial system of the limb remains intact (Figure 3). These doubts are not held by reconstruction surgeons alone.…”

Section: Discussionmentioning

confidence: 99%

The Radial Artery’s Sacrifice in the Chinese Flap Is Not Deleterious to Patients

Costa

Viecili

Sambuy

et al. 2016

Hand (New York, N,Y.)

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A widely discussed subject, albeit with few associated studies and publications, centers on whether sacrifice of the radial artery to perform the radial forearm flap (RFF) is deleterious to the patient. The objective of this study was to assess, by questionnaire, the complications reported at the donor site, particularly those related to sacrifice of the radial artery. During the 2014 Symposium of the Brazilian Society of Reconstructive Microsurgery, surgeons were asked to answer a questionnaire on RFF cases and complications. Results were collected from hand and plastic surgeons. Regarding the opinion of respondents on the deleteriousness of sacrificing the radial artery, most answered negatively, that is, no deleterious effects reported. No statistically significant difference was found between the level of experience and opinion on whether sacrificing the radial artery was deleterious. Beyond performing some procedures and following evolution within a specific service, it was decided to broaden the range of opinions and enlarge the casuistic by assessing the opinions of many specialists from the fields of hand surgery and plastic surgery. Data collected using the questionnaire were compared to determine the sequelae at the donor site and particularly whether sacrifice of the radial artery in RFF was deleterious to the patient. Although complaints at the donor site were frequently cited, no objective reports on morbidity following the sacrifice of the radial artery in RFF were provided.

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“…With patency rates of internal mammary arterial graft conduits reaching 95% at 10 y postoperatively [14 -16], the conceptual benefit of total arterial revascularization has also contributed to the increased use of the RA as a conduit. Since then, other groups have encouraged the use of RA grafts based on excellent results [2,[17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Local Sensorimotor Deficits After Radial Artery Harvesting for Coronary Artery Bypass Grafting

Shah

Chark

Williams

et al. 2007

Journal of Surgical Research

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Does radial artery harvesting for coronary revascularization cause neurological injury in the forearm and hand?

Abstract: We advocate that removal of RA does not lead to any major neurologic hand complications in the presence of adequate collateral arterial blood supply. ENMG studies confirmed minimal conduction alterations with no statistical significance, even if neurologic symptoms were stated.

Cited by 21 publications

References 16 publications

Endoscopic Radial Artery Harvesting: Patient Satisfaction and Complications

Endoscopic Radial Artery Harvesting: Patient Satisfaction and Complications

The Radial Artery’s Sacrifice in the Chinese Flap Is Not Deleterious to Patients

Retrospective Analysis of Local Sensorimotor Deficits After Radial Artery Harvesting for Coronary Artery Bypass Grafting

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