Hand perfusion with 99mTc-HSA in patients expecting to undergo coronary bypass surgery: elaboration of a new complex diagnostic protocol for the safe removal of a radial artery graft

Abstract

Hand perfusion with (99m)Tc-HSA is useful in patients selected for coronary bypass operations, so we recommend the introduction of this method as a routine examination before the removal of the radial artery in patients with an abnormal Allen test.

Is radial artery Doppler scanning mandatory for use as coronary bypass conduit?

“…Even scintigraphy for screening palmer circulation has been suggested by Garai and colleagues. 18 It has further been shown that RA conduits otherwise considered acceptable for bypass grafting, were often found by optical coherence tomography to have a substantial amount of lipid, which strongly correlates with the risk of postoperative spasm. 19 Screening conduits based on characteristics of intimal quality may the improve the results of RA grafting, yet one has to keep logistics as cost-benefit issues in mind before advocating additional tests as routine for picking up just that one extra anecdotal case.…”

Neurovascular Complications of the Upper Extremity Following Cardiovascular Procedures

“…Additionally, some clinicians espouse the use of more advanced preoperative testing. Specifically, Garai et al 28 recommend performing hand perfusion studies with the injection of technetium 99-m labeled human serum albumin in patients with an abnormal Allen's test to identify those who are truly at an increased risk of hand ischemia following radial artery harvest for coronary artery bypass grafting. An abnormal Allen's test is often defined as the inability of the hand to flush within 15 seconds after releasing occlusive pressure on the ulnar artery.…”