Limb Performance and Patient Satisfaction After Radial Artery Harvesting: Endoscopic Versus Open Techniques

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2008 Feb 22

PMID 18288529

Citations 2

Authors

Benjamin Medalion

Avraham Fuks

Erez Sharoni

Alon Stamler

Eitan Snir

Bernardo Vidne

Eyal Porat

Affiliations

Soon will be listed here.

Abstract

Background: The differences in hand functionality after harvesting the radial artery for coronary artery bypass grafting (CABG) in an endoscopic technique relative to open technique are unclear.

Methods: One hundred and sixty-four patients who had CABG and their non dominant hand radial artery was harvested either in an open technique (n = 92) or in an endoscopic technique (n = 72) in a period of 9.8 +/- 3.5 months after the operation were studied. Surgical technique was surgeon specific. Patients were asked either five questions (endoscopic group), or six questions (open group), to assess how radial artery harvesting affected them.

Results: Significantly more patients in the open group experienced significant limitations in their work and regular daily activities (12% versus 0%, p = 0.02), social activities (13% versus 0%, p = 0.005), and experienced significant pain (8% versus 0%, p = 0.04) compared with the endoscopic group. More patients in the open group complained that their arm incision disturb them (24% versus 10%, p = 0.01). Forty-two patients (46%) in the open group would prefer smaller incision. A "limitation score" variable was created from the first four questions to reflect overall functionality. Severe limitation was present in 3% of the open group versus 0% in the endoscopic group (p = 0.04). Female sex and open harvesting technique were found to be independently associated with higher limitation score.

Conclusions: After a mean of 9.8 months after surgery, patients reports good overall upper-limb function. However, more patients in the open technique had significant disabilities and dissatisfaction.

Citing Articles

Radial artery harvesting in coronary artery bypass grafting surgery-Endoscopic or open method? A meta-analysis.

Huang T, Huang T, Cheng Y, Wang Y, Chen T, Yin S PLoS One. 2020; 15(7):e0236499.

PMID: 32706808 PMC: 7380611. DOI: 10.1371/journal.pone.0236499.

Endoscopic versus open radial artery harvest and mammario-radial versus aorto-radial grafting in patients undergoing coronary artery bypass surgery: protocol for the 2 × 2 factorial designed randomised NEO trial.

Carranza C, Ballegaard M, Werner M, Hasbak P, Kjaer A, Kofoed K Trials. 2014; 15:135.

PMID: 24754891 PMC: 4033613. DOI: 10.1186/1745-6215-15-135.

References

Desai N, Cohen E, Naylor C, Fremes S . A randomized comparison of radial-artery and saphenous-vein coronary bypass grafts. N Engl J Med. 2004; 351(22):2302-9. DOI: 10.1056/NEJMoa040982. View

Meharwal Z, Trehan N . Functional status of the hand after radial artery harvesting: results in 3,977 cases. Ann Thorac Surg. 2001; 72(5):1557-61. DOI: 10.1016/s0003-4975(01)03088-0. View

Casselman F, La Meir M, Cammu G, Wellens F, De Geest R, Degrieck I . Initial experience with an endoscopic radial artery harvesting technique. J Thorac Cardiovasc Surg. 2004; 128(3):463-6. DOI: 10.1016/j.jtcvs.2004.05.002. View

Sajja L, Mannam G, Pantula N, Sompalli S . Role of radial artery graft in coronary artery bypass grafting. Ann Thorac Surg. 2005; 79(6):2180-8. DOI: 10.1016/j.athoracsur.2004.07.049. View

Parolari A, Rubini P, Alamanni F, Cannata A, Xin W, Gherli T . The radial artery: which place in coronary operation?. Ann Thorac Surg. 2000; 69(4):1288-94. DOI: 10.1016/s0003-4975(99)01089-9. View

Khot U, Friedman D, Pettersson G, Smedira N, Li J, Ellis S . Radial artery bypass grafts have an increased occurrence of angiographically severe stenosis and occlusion compared with left internal mammary arteries and saphenous vein grafts. Circulation. 2004; 109(17):2086-91. DOI: 10.1161/01.CIR.0000127570.20508.5C. View

Saeed I, Anyanwu A, Yacoub M, Amrani M . 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. Eur J Cardiothorac Surg. 2001; 20(6):1142-6. DOI: 10.1016/s1010-7940(01)00989-7. View

Connolly M, Torrillo L, Stauder M, Patel N, McCabe J, Loulmet D . Endoscopic radial artery harvesting: results of first 300 patients. Ann Thorac Surg. 2002; 74(2):502-5; discussion 506. DOI: 10.1016/s0003-4975(02)03717-7. View

Reyes A, Frame R, Brodman R . Technique for harvesting the radial artery as a coronary artery bypass graft. Ann Thorac Surg. 1995; 59(1):118-26. DOI: 10.1016/0003-4975(94)00673-U. View

10.

Georghiou G, Vidne B, Dunning J . Does the radial artery provide better long-term patency than the saphenous vein?. Interact Cardiovasc Thorac Surg. 2007; 4(4):304-10. DOI: 10.1510/icvts.2005.107490. View

11.

Denton T, Trento L, Cohen M, Kass R, Blanche C, Raissi S . Radial artery harvesting for coronary bypass operations: neurologic complications and their potential mechanisms. J Thorac Cardiovasc Surg. 2001; 121(5):951-6. DOI: 10.1067/mtc.2001.112833. View

12.

Royse A, Royse C, Shah P, Williams A, Kaushik S, Tatoulis J . Radial artery harvest technique, use and functional outcome. Eur J Cardiothorac Surg. 1999; 15(2):186-93. DOI: 10.1016/s1010-7940(98)00311-x. View

13.

Caputo M, Reeves B, Marchetto G, Mahesh B, Lim K, Angelini G . Radial versus right internal thoracic artery as a second arterial conduit for coronary surgery: early and midterm outcomes. J Thorac Cardiovasc Surg. 2003; 126(1):39-47. DOI: 10.1016/s0022-5223(02)73254-6. View

14.

Carpentier A, Guermonprez J, Deloche A, Frechette C, Dubost C . The aorta-to-coronary radial artery bypass graft. A technique avoiding pathological changes in grafts. Ann Thorac Surg. 1973; 16(2):111-21. DOI: 10.1016/s0003-4975(10)65825-0. View

15.

Tatoulis J, Buxton B, Fuller J . Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg. 2004; 77(1):93-101. DOI: 10.1016/s0003-4975(03)01331-6. View

16.

Calafiore A, Di Mauro M, DAlessandro S, Teodori G, Vitolla G, Contini M . Revascularization of the lateral wall: long-term angiographic and clinical results of radial artery versus right internal thoracic artery grafting. J Thorac Cardiovasc Surg. 2002; 123(2):225-31. DOI: 10.1067/mtc.2002.119704. View

17.

Patel A, Henry A, Hunnicutt C, Cockerham C, Willey B, Urschel Jr H . Endoscopic radial artery harvesting is better than the open technique. Ann Thorac Surg. 2004; 78(1):149-53. DOI: 10.1016/j.athoracsur.2004.03.001. View

18.

Acar C, Ramsheyi A, Pagny J, Jebara V, Barrier P, Fabiani J . The radial artery for coronary artery bypass grafting: clinical and angiographic results at five years. J Thorac Cardiovasc Surg. 1998; 116(6):981-9. DOI: 10.1016/S0022-5223(98)70050-9. View