Abstract
Objectives: The radial artery is used as a second arterial conduit in coronary artery bypass surgery. However, concerns exist about the thermal injury incurred to the radial artery during endoscopic harvest. We sought to assess this effect both histologically and radiologically. Methods: From February 2015 to March 2016, 50 consecutive patients undergoing coronary artery bypass surgery utilizing endoscopically harvested radial artery were prospectively studied. Computerized tomography coronary angiography scan was performed randomly in 8 patients who also had their respective radial artery analyzed histologically at the time of harvest. Standard coronary angiography was also performed in 4 additional patients driven by symptoms recurrence. Results: All patients were available for follow up at 1 year following the surgery. There was no mortality during follow-up. Three patients (6%) developed transient complications in the harvest arm which resolved. All radial arteries were patent on follow-up imaging. Histological examination showed integrity of the arterial wall, intact endothelial lining, patent lumens and no significant pathological abnormalities. Conclusion: The use of endoscopic radial artery harvest was associated with few self-limiting morbidities and excellent patency rates. In addition, there was no evidence of any thermal or traumatic injuries sustained to the radial arteries when examined histologically. The use of endoscopically harvested radial arteries appears safe with excellent results.
Highlights
The radial artery is increasingly used as a second arterial conduit in coronary artery bypass graft (CABG) surgery [1] [2]
The use of endoscopic radial artery harvest is gaining popularity in recent years owing to smaller incisions, greater patient satisfaction and less complications in the harvested arm while maintaining similar patency rates to the radial artery harvested by open technique [3] [4] [5]
There are still some concerns that by using endoscopic harvesting technique, the radial artery might be compromised by thermal injury which may lead to inferior long-term patency rates [6]
Summary
The radial artery is increasingly used as a second arterial conduit in coronary artery bypass graft (CABG) surgery [1] [2]. This has been largely due to its excellent patency rates and adequate length with less morbidity associated with its harvest. There are still some concerns that by using endoscopic harvesting technique, the radial artery might be compromised by thermal injury which may lead to inferior long-term patency rates [6]. We sought to assess the effect of endoscopic radial artery harvest on thermal injury incurred to the radial artery both histologically and radiologically. We report our results of endoscopic radial artery harvest both in the short and mid-term
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