Skeletonized or Pedicled Harvesting of Left Internal Mammary Artery: A Systematic Review and Meta-analysis

Comparison of Long-term Clinical Outcomes of Skeletonized vs Pedicled Internal Thoracic Artery Harvesting Techniques in the Arterial Revascularization Trial

“…However, histologic and functional studies have reported comparable endothelial integrity and function with the 2 techniques . Also, individual studies and meta-analysis of observational studies have reported similar clinical outcomes and patency rates for skeletonized and pedicled ITAs …”

“…This is important because sternal wound infection is associated with ITA use and is a strong risk factor for early and late mortality after CABG as well as adverse postoperative events and prolonged in-hospital stay . Skeletonization has also been associated with superior ITA length and higher free flow that can potentially facilitate CABG and is currently recommended in expert consensus documents and professional societies guidelines …”

Intraoperative Assessment of Sternal Perfusion During Coronary Artery Bypass Grafting: A Pilot Study

“…Nuclear imaging has been used to assess sternal perfusion during CABG, which offers limited clinical utility and application. 3,4 Medalion et al demonstrated that the perfusion decrement associated with IMA harvesting resolved over the approximately 20-month follow-up period. 5 Thus, future study of the SPY system will focus on quantification of clinically significant intraoperative perfusion deficits.…”

Advancing coronary artery bypass grafting: the fasudil-nitroglycerin cocktail as a potential antispastic solution

“…In addition, it may be particularly important to consider the form of harvesting used by the surgeons performing CABG. While the ITA is generally harvested with its pedicle of perivascular fat (PVF) intact, in many cases the ITA is ‘skeletonized’, where the PVF is removed ( 13 , 14 ), a procedure that may affect spasm when compared with pedicled ITA. Furthermore, in vitro , organ bath studies have shown a vasodilatory effect of human ITA PVF that involves calcium-dependent potassium channels ( 15 ).…”