Endoscopic radial artery harvesting for coronary artery bypass grafting

Abstract

This article summarizes the current research on endoscopic technique of radial artery harvesting as a graft for coronary artery bypass grafting (CABG) surgery. Based on the available data, we reviewed various grafts available for CABG. Radial artery as a graft in CABG surgery has recently gained popularity. We sought to investigate the impact of radial artery harvesting techniques on clinical outcomes. Endoscopic harvest approach was found to be feasible in all patients when performed by skillful surgeon while local arm complications were found to be infrequent. However, when compared to open approach for harvest, it takes longer but provides higher patient satisfaction and cosmetic result.

Keywords

Endoscopic radial artery harvesting / coronary artery bypass grafting / harvesting techniques / wound complication / endoscopic technique cost / patency rates

References

[1] Kolh P,Alfonso F,Cremer J.2014 ESC/EACTS guidelines on myocardial revascularization: the task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)..Eur J Cardiothorac Surg2014;46:517-92

[2] Arisha MJ,Abouarab AA,Hussein MKK.Percutaneous coronary intervention in the elderly: current updates and trends. Avialible from: https://www.researchgate.net/publication/326272491_Percutaneous_coronary_intervention_in_the_elderly_current_updates_and_trends. [Last accessed on 11 Oct 2018]

[3] Martínez-González B,Quiroga-Garza A,Esparza-Hernández CN.Conduits used in coronary artery bypass grafting: a review of morphological studies..Ann Thorac Cardiovasc Surg2017;23:55-65 PMCID:PMC5422630

[4] Desai M,Hamilton G..Role of prosthetic conduits in coronary artery bypass grafting..Eur J Cardiothorac Surg2011;40:394-8

[5] Parang P.Coronary vein graft disease: pathogenesis and prevention..Can J Cardiol2009;25:e57-62

[6] Gaudino M,Pragliola C,Burzotta F.Arterial versus venous bypass grafts in patients with in-stent restenosis..Circulation2005;112:I265-9

[7] Carpentier A,Deloche A,DuBost C..The aorta-to-coronary radial artery bypass graft. A technique avoiding pathological changes in grafts..Ann Thorac Surg1973;16:111-21

[8] Curtis JJ,Alford WC Jr,Thomas CS Jr.Intimal hyperplasia. A cause of radial artery aortocoronary bypass graft failure..Ann Thorac Surg1975;20:628-35

[9] Gaudino M,Fremes S,Sedrakyan A.Radial-artery or saphenous-vein grafts in coronary-artery bypass surgery..N Engl J Med2018;378:2069-77

[10] Aldea GS,Pal J,Head SJ.The society of thoracic surgeons clinical practice guidelines on arterial conduits for coronary artery bypass grafting..Ann Thorac Surg2016;101:801-9

[11] Goldman S,Holman W,McFalls E.Radial artery grafts vs saphenous vein grafts in coronary artery bypass surgery: a randomized trial..JAMA2011;305:167-74

[12] Schwann TA,Yammine MB,Engoren M.Incremental value of increasing number of arterial grafts: the effect of diabetes mellitus..Ann Thorac Surg2018;105:1737-44

[13] Hoffman DM,Lucido DJ,Geller CM.Optimal conduit for diabetic patients: propensity analysis of radial and right internal thoracic arteries..Ann Thorac Surg2014;98:30-7

[14] WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy.2010;GenevaWorld Health OrganizationAnnex I, Modified Allen test. Available from: https://www.ncbi.nlm.nih.gov/books/NBK138652/. [Last accessed on 15 Oct 2018]

[15] Jarvis MA,Jones PRM.Reliability of Allen’s test in selection of patients for radial artery harvest..Ann Thorac Surg2000;70:1362-5

[16] Gaudino M,Cammertoni F,Toesca A.Technical issues in the use of the radial artery as a coronary artery bypass conduit..Ann Thorac Surg2014;98:2247-54

[17] Starnes SL,Lampman RM,Prager RL.Noninvasive evaluation of hand circulation before radial artery harvest for coronary artery bypass grafting..J Thorac Cardiovasc Surg1999;117:261-6

[18] Buxton BF,Dixit AS,Marshall RD.Ulnar artery as a coronary bypass graft..Ann Thorac Surg1998;65:1020-4

[19] Newcomb A,Buxton BF.He GW.Ulnar artery as a coronary artery bypass graft: five-year experience..Arterial grafting for coronary artery bypass surgery.2006;BerlinSpringer227-32

[20] Gaudino M,Bakaeen F,Crea F.The radial artery for percutaneous coronary procedures or surgery?.J Am Coll Cardiol2018;71:1167-75

[21] Rashid M,Pancholy S,Kedev SA.Radial artery occlusion after transradial interventions: a systematic review and meta-analysis..J Am Heart Assoc2016;5:e002686 PMCID:PMC4859386

[22] Mounsey CA,Werner RS.Does previous transradial catheterization preclude use of the radial artery as a conduit in coronary artery bypass surgery?.Circulation2016;134:681-8

[23] Calafiore AM,Teodori G,Vitolla G.Radial artery and inferior epigastric artery in composite grafts: improved midterm angiographic results..Ann Thorac Surg1995;60:517-23; discussion 523-4

[24] Brodman RF,Camacho M,Chen A.Routine use of unilateral and bilateral radial arteries for coronary artery bypass graft surgery..J Am Coll Cardiol1996;28:959-63

[25] Risteski PS,Moritz A.The radial artery as a conduit for coronary artery bypass grafting: review of current knowledge..Anadolu Kardiyol Derg2006;6:153-62

[26] Tatoulis J,Fuller JA.Patencies of 2127 arterial to coronary conduits over 15 years..Ann Thorac Surg2004;77:93-101

[27] Glineur D.Competitive flow and arterial graft a word of caution..Eur J Cardiothorac Surg2012;41:768-9

[28] Baikoussis NG,Apostolakis E..Radial artery as graft for coronary artery bypass surgery: advantages and disadvantages for its usage focused on structural and biological characteristics..J Cardiol2014;63:321-8

[29] Amano A,Hirose H..Skeletonized radial artery grafting: improved angiographic results..Ann Thorac Surg2002;73:1880-7

[30] Rukosujew A,Fabricius AM,Tjan TD.Skeletonization versus pedicle preparation of the radial artery with and without the ultrasonic scalpel..Ann Thorac Surg2004;77:120-5

[31] Discigil B,Pearson PJ,Rodrigues AJ.High-frequency ultrasonic waves cause endothelial dysfunction on canine epicardial coronary arteries..Braz J Cardiovasc Surg2008;23:190-6

[32] Blitz A,Brodman RF.Harvesting the radial artery..Ann Cardiothorac Surg2013;2:533-42 PMCID:PMC3741868

[33] Navia JL,Ehasz P,Svensson LG.Endoscopic radial artery harvesting procedure for coronary artery bypass grafting..Ann Cardiothorac Surg2013;2:557-64 PMCID:PMC3741886

[34] Navia JL,Chiu J,Atik FA.Endoscopic versus open radial artery harvesting for coronary artery bypass grafting..J Cardiovasc Surg (Torino)2012;53:257-63 PMCID:PMC4033613

[35] Shapira OM,Anter E,Christensen TG.Endoscopic versus conventional radial artery harvest for coronary artery bypass grafting: functional and histologic assessment of the conduit..J Thorac Cardiovasc Surg2006;131:388-94

[36] Rahouma M,Benedetto U,Di Franco A.Endoscopic versus open radial artery harvesting: a meta-analysis of randomized controlled and propensity matched studies..J Card Surg2017;32:334-41

[37] Krishnamoorthy B,Venkateswaran RV,Caress A.A comprehensive review on learning curve associated problems in endoscopic vein harvesting and the requirement for a standardised training programme..J Cardiothorac Surg2016;11:45 PMCID:PMC4825086

[38] Kiaii BB,Fox SA,Quantz MA.A prospective randomized study of endoscopic versus conventional harvesting of the radial artery..Innovations (Phila)2017;12:231-8

[39] Acar C,Portoghese M,Pagny JY.Revival of the radial artery for coronary artery bypass grafting..Ann Thorac Surg1992;54:652-60

[40] Ikeda M,Tsutsumi Y,Kawai T.Angiographic evaluation of the luminal changes in the radial artery graft in coronary artery bypass surgery: a concern over the long-term patency..Eur J Cardiothorac Surg2002;21:800-3

[41] Desai ND,Naylor CD.A randomized comparison of radial-artery and saphenous-vein coronary bypass grafts..N Engl J Med2004;351:2302-9

[42] Al-Sabti HA,Al-Rasadi K,Al-Hashmi K.Saphenous vein graft vs. radial artery graft searching for the best second coronary artery bypass graft..J Saudi Heart Assoc2013;25:247-54 PMCID:PMC3818632

[43] Tatoulis J,Fuller JA,Theodore S.Long-term patency of 1108 radial arterial-coronary angiograms over 10 years..Ann Thorac Surg2009;88:23-9; discussion 29-30

[44] Gaudino M,Benedetto U,Flore R.Radial artery as a coronary artery bypass conduit: 20-year results..J Am Coll Cardiol2016;68:603-10

[45] He GW.Spasm in arterial grafts in coronary artery bypass grafting surgery..Ann Thorac Surg2016;101:1222-9

[46] Myers MG.Prevention of radial artery graft spasm: a survey of Canadian surgical centres..Can J Cardiol2003;19:677-81

[47] Reyes AT,Brodman RF.Technique for harvesting the radial artery as a coronary artery bypass graft..Ann Thorac Surg1995;59:118-26

[48] Chanda J,Canver CC.Prevention of radial artery graft vasospasm after coronary bypass..Ann Thorac Surg2000;70:2070-4

[49] Gaudino M,Caradonna E,Burzotta F.Implantation in coronary circulation induces morphofunctional transformation of radial grafts from muscular to elastomuscular..Circulation2005;112:I208-11

[50] Patel A,Dunning J..Should patients receiving a radial artery conduit have post-operative calcium channel blockers?.Interact Cardiovasc Thorac Surg2006;5:251-7

[51] Royse AG,Shah P,Kaushik S.Radial artery harvest technique, use and functional outcome..Eur J Cardiothorac Surg1999;15:186-93

[52] Meharwal ZS.Functional status of the hand after radial artery harvesting: results in 3,977 cases..Ann Thorac Surg2001;72:1557-61

[53] Denton TA,Cohen M,Blanche C.Radial artery harvesting for coronary bypass operations: neurologic complications and their potential mechanisms..J Thorac Cardiovasc Surg2001;121:951-6

[54] Patel AN,Hunnicutt C,Willey B.Endoscopic radial artery harvesting is better than the open technique..Ann Thorac Surg2004;78:149-53

[55] Bisleri G,Hrapkowicz T,Zembala M.Five-year clinical outcome of endoscopic versus open radial artery harvesting: a propensity score analysis..Ann Thorac Surg2016;102:1253-9

[56] Burns DJP,Fox SA,Vezina W.Long-term patency of endoscopically harvested radial arteries: from a randomized controlled trial..Innovations (Phila)2015;10:77-84

[57] Rahouma M,Benedetto U,Di Franco A.Endoscopic versus open radial artery harvesting: a meta-analysis of randomized controlled and propensity matched studies..J Card Surg2017;32:334-41

[58] Yoshizaki T,Igari T,Tanaka H.Endoscopic radial artery harvesting: our initial experience and results of the first 25 patients..Ann Thorac Cardiovasc Surg2005;11:391

[59] Casselman FP,Cammu G,De Geest R.Initial experience with an endoscopic radial artery harvesting technique..J Thorac Cardiovasc Surg2004;128:463-6

[60] Karimi A,Davoodi S,Marzban M.Factors affecting postoperative morbidity and mortality in isolated coronary artery bypass graft surgery..Surg Today2008;38:890-8

[61] Gonzalez LF,Lekovic GP,Spetzler RF.Endoscopic harvesting of the radial artery for neurovascular bypass..Neurosurg Focus2008;24:E10

[62] Buxton BF,Newcomb AE,Seevanayagam S.Choice of conduits for coronary artery bypass grafting: craft or science?.Eur J Cardiothorac Surg2009;35:658-70

[63] Zacharias A,Riordan CJ,Shah AS.Late results of conventional versus all-arterial revascularization based on internal thoracic and radial artery grafting..Ann Thorac Surg2009;87:19-26.e2

[64] Aronson S,Lapp W..Isolated systolic hypertension is associated with adverse outcomes from coronary artery bypass grafting surgery..Anesth Analg2002;94:1079-84, table of contents