Intraoperative and Histochemical Comparison of the Skeletonized and Pedicled Internal Thoracic Artery

Abstract

Although skeletonization of the ITA is a more technically demanding procedure, it provides some advantages such as increased available graft length and reduced sternal devascularization. This technique did not have any detrimental effects on the endothelial cell lining and e-NOS expressions on the endothelial layer. To reach a definitive judgment for using skeletonized ITA, we need information about the long-term angiographic patency rates.

Topical vasodilator response in skeletonized internal mammary artery: Is there really a difference?

“…also highlighted that skeletonization is associated with increased length of the conduit (15.7+/-0.4 cm in pedicled group versus 19.0 ± 0.6 cm in skeletonized group; P = 0.001). [2526] The small variation that is obtained in lengths of these grafts among different studies may be due to skeletonization technique, vasodilator use, and preferences in selection of patients. Increased conduit length may have great significance in the surgery outcome as it allows easy revascularization distally[21] and composite grafting.…”

Assessment of the Association of Bilateral Internal Thoracic Artery Skeletonization and Sternal Wound Infection After Coronary Artery Bypass Grafting

“…Skeletonization of the internal thoracic artery was derived as a strategy to limit the degree of devascularization during conduit harvest by the intentional preservation of collateral branches and the venous supply of the chest wall [5]. This technique has been proven to preserve sternal blood flow and to minimize postoperative pain [6], and it has been advocated as an attractive method to decrease the incidence of SWI, particularly among highrisk patients such as those with diabetes mellitus [7].…”

Off-pump Skeletonized Versus Pedicled Left Internal Mammary Artery Grafting: Mid-term Results

“…One of the major advantages of skeletonized conduits is the potential longer length for grafting. Many studies have demonstrated an increased conduit length by skeletonization, which offers extra advantages . However, an important intra‐patient comparison study showed only a small trend in increased conduit length by skeletonization, with no statistically significant difference .…”

“…Many studies have demonstrated an increased conduit length by skeletonization, which offers extra advantages. 6,14 However, an important intra-patient comparison study showed only a small trend in increased conduit length by skeletonization, with no statistically significant difference. 11 In the present study, skeletonized LIMAs showed significantly greater length and LIMA/sternum length ratio compared with pedicled ones.…”