Subjective patient outcomes following coronary artery bypass using the radial artery: results of a cross-sectional survey of harvest site complications and quality of life

Abstract

Sensory symptoms following radial artery procurement occur more frequently than previously reported, but are largely self-limiting and are usually clinically insignificant. Patients appear to have a good quality of life following CABG using the radial artery. Radial artery harvest may be associated with lower wound infection rates and greater patient satisfaction than LSV harvest, however, the presence of residual sensory symptoms may be of relevance when obtaining informed consent.

Endoscopic radial artery harvesting for coronary artery bypass grafting. A single center evolving experience

“…The risk of severe post-harvesting complications leading to hand disability as a consequence of hand ischemia or major neuronal trauma is extremely rare if the surgical technique and pre-operative hand collateral blood flow evaluation are carried out properly 2,7,12 . However, neuropathic sensory disturbances in the terminal area of the superficial branch of the radial nerve (SBRN), lateral antebrachial cutaneous nerve (LACN), and sensory part of median nerve (MN) are clinically detectable in 12-51% of cases in the postoperative period and even persist in 8-12% patients 1 year after the surgery 3,13,14 . In addition, in 3-5% of patients had some motor deficit which was caused by injury to the median or the motor branch of the radial nerve 14 .…”

“…However, neuropathic sensory disturbances in the terminal area of the superficial branch of the radial nerve (SBRN), lateral antebrachial cutaneous nerve (LACN), and sensory part of median nerve (MN) are clinically detectable in 12-51% of cases in the postoperative period and even persist in 8-12% patients 1 year after the surgery 3,13,14 . In addition, in 3-5% of patients had some motor deficit which was caused by injury to the median or the motor branch of the radial nerve 14 . According to neurophysiologic study, axonal degeneration lesions of radial and median nerve are detectable almost in 70% cases 15,16 .…”

“…This aside, there is also a risk of microvascular malperfusion despite the competency of collateral flow 3,13 . Some sensory loss and/or motor weakness following RA harvesting, mostly in the thumb area, can be perceived very sensitively by the patient, particularly when it produces some hand limitation in regular or work activities even when the impairment was assessed as minor or negligible by the physician 14 . Evolving experience with endoscopic vein harvesting shows significant reduction in harvesting site-related complications.…”

Arterielle Revaskularisation der Koronargefäße

“…Die Seitenäste werden entweder geklippt oder mit dem Ultraschallmesser verödet. Temporäre Sensibiltätsstörungen (Thenar) treten zwar initial häu-fig auf (60%), sind aber schnell regredient; Wundheilungsstörungen (6%) und Kraftminderung (3%) sind selten; über eine unzureichende Kollateralversorgung über die Arteria ulnaris existieren lediglich Fallberichte [28]. Auch bei Diabetikern ist die Arterie zur Revaskularisation geeignet, da die endothelabhängige Relaxation erhalten bleibt [36].…”

Limb performance and patient satisfaction after radial artery harvesting: endoscopic versus open techniques

“…After initial disappointment due to low patency rates the procedure was abandoned. Since the mid 1990s there has been renewed interest in this conduit and several articles have documented its patency rates as well as its rate of complications [2][3][4][5][6][7][8][9][10], which seems to be more prevalent then previously thought [3,8]. In those studies the radial artery was harvested in an open technique.…”