No change of palmar microcirculation at rest 2 years after radial artery harvesting

Abstract

Radial artery forearm flaps are used for reconstruction of soft tissue defects. However, the functional consequences of removal of the radial artery for hand perfusion remain unclear at rest. We hypothesised that baseline microcirculation at rest is different following removal of the radial artery in a long-term perspective. 114 atherosclerotic patients (100 males, 61.7+/-6.7 years) were included undergoing elective coronary revascularisation using the radial artery of the non-dominant forearm with non-pathological Allen's Test. Resting palmar microcirculatory mapping was applied at 25+/-5 months following removal of the radial artery regarding capillary flow, finger tip oxygenation as well as postcapillary venous filling pressures at both hands using combined non-invasive real-time laser Doppler flowmetry and spectrophotometry. 54/56 positions, more than 2 years following radial artery removal, did not reveal a difference beyond a 5% threshold at rest. No clinical signs of malperfusion were found following radial artery removal. No patient was impaired in his daily palmar motor activity or suffered exercise-related signs of malperfusion. Superficial and deep oxygen saturation decreased with age. In the non-donor hand, oxygen saturation declined in the first and second digits. Postcapillary venous filling pressure in both thenars increased with age. The hypothesis was rejected. Pedicled removal of the radial artery does not compromise superficial or deep palmar capillary blood flow, finger tip oxygenation or postcapillary venous filling pressures among atherosclerotic patients at rest in a clinically significant way.