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

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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.

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References

  1. Carpentier A, Guermonprez JL, Deloche A, Frechette C, DuBost C (1973) The aorta-to-coronary radial artery bypass graft. A technique avoiding pathological changes in grafts. Ann Thorac Surg 16:111–121

    Article  PubMed  CAS  Google Scholar 

  2. Acar C, Ramsheyi A, Pagny JY, Jebara V, Barrier P, Fabiani JN, Deloche A, Guermonprez JL, Carpentier A (1998) The radial artery for coronary artery bypass grafting: clinical and angiographic results at five years. J Thorac Cardiovasc Surg 116:981–989

    Article  PubMed  CAS  Google Scholar 

  3. Denton TA, Trento L, Cohen M, Kass RM, Blanche C, Raissi S, Cheng W, Fontana GP, Trento A (2001) Radial artery harvesting for coronary bypass operations: neurologic complications and their potential mechanisms. J Thorac Cardiovasc Surg 121:951–956

    Article  PubMed  CAS  Google Scholar 

  4. Desai ND, Cohen EA, Naylor CD, Fremes SE, the Radial Artery Patency Study Investigators (2004) A randomized comparison of radial-artery and saphenous-vein coronary bypass grafts. N Engl J Med 351:2302–2309

    Article  PubMed  CAS  Google Scholar 

  5. Meharwal ZS, Trehan N (2001) Functional status of the hand after radial artery harvesting: results in 3,977 cases. Ann Thorac Surg 72:1557–1561

    Article  PubMed  CAS  Google Scholar 

  6. Parolari A, Rubini P, Alamanni F, Cannata A, Xin W, Gherli T, Polvani GL, Toscano T, Zanobini M, Biglioli P (2000) The radial artery: which place in coronary operation? Ann Thorac Surg 69:1288–1294

    Article  PubMed  CAS  Google Scholar 

  7. Royse AG, Royse CF, Shah P, Williams A, Kaushik S, Tatoulis J (1999) Radial artery harvest technique, use and functional outcome. Eur J Cardiothorac Surg 15:186–193

    Article  PubMed  CAS  Google Scholar 

  8. Saeed I, Anyanwu AC, Yacoub MH, Amrani M (2001) 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 20:1142–1146

    Article  PubMed  CAS  Google Scholar 

  9. Sajja LR, Mannam G, Pantula NR, Sompalli S (2005) Role of Radial Artery Graft in Coronary Artery Bypass Grafting. Ann Thorac Surg 79:2180–2188

    Article  PubMed  Google Scholar 

  10. Tatoulis J, Buxton BF, Fuller JA (2004) Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg 77:93–101

    Article  PubMed  Google Scholar 

  11. Casselman FP, La Meir M, Cammu G, Wellens F, De Geest R, Degrieck I, Van Praet F, Vermeulen Y, Vanermen H (2004) Initial experience with an endoscopic radial artery harvesting technique. J Thorac Cardiovasc Surg 128:463–466

    Article  PubMed  CAS  Google Scholar 

  12. Connolly MW, Torrillo LD, Stauder MJ, Patel NU, McCabe JC, Loulmet DF, Subramanian VA (2002) Endoscopic radial artery harvesting: results of first 300 patients. Ann Thorac Surg 74:502–505

    Article  PubMed  Google Scholar 

  13. Patel AN, Henry AC, Hunnicutt C, Cockerham CA, Willey B, Urschel HC Jr (2004) Endoscopic radial artery harvesting is better than the open technique. Ann Thorac Surg 78:149–153

    Article  PubMed  Google Scholar 

  14. Reyes AT, Frame R, Brodman RF (1995) Technique for harvesting the radial artery as a coronary artery bypass graft. Ann Thorac Surg 59:118–126

    Article  PubMed  CAS  Google Scholar 

  15. Calafiore AM, Di Mauro M, D’Alessandro S, Teodori G, Vitolla G, Contini M, Iaco AL, Spira G (2002) Revascularization of the lateral wall: long-term angiographic and clinical results of radial artery versus right internal thoracic artery grafting. J Thorac Cardiovasc Surg 123:225–231

    Article  PubMed  Google Scholar 

  16. Caputo M, Reeves B, Marchetto G, Mahesh B, Lim K, Angelini GD (2003) Radial versus right internal thoracic artery as a second arterial conduit for coronary surgery: early and midterm outcomes. J Thorac Cardiovasc Surg 126:39–47

    Article  PubMed  Google Scholar 

  17. Georghiou GP, Vidne BA, Dunning J (2005) Does the radial artery provide better long-term patency than the saphenous vein? Interact CardioVasc Thorac Surg 4:304–310

    Article  PubMed  Google Scholar 

  18. Khot UN, Friedman DT, Pettersson G, Smedira NG, Li J, Ellis SG (2004) 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 109:2086–2091

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Rabin Medical Center (Affiliated with Tel Aviv University, Tel Aviv), Beilinson Campus, 39 Jabotinsky Street, Petach Tikva, 49100, Israel

    Benjamin Medalion, Avraham Fuks, Erez Sharoni, Alon Stamler, Eitan Snir, Bernardo Vidne & Eyal Porat

Authors
  1. Benjamin Medalion
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  2. Avraham Fuks
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  3. Erez Sharoni
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  4. Alon Stamler
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  5. Eitan Snir
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  6. Bernardo Vidne
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  7. Eyal Porat
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Corresponding author

Correspondence to Benjamin Medalion.

Appendix: questions asked

Appendix: questions asked

On a scale of 1 to 5, where 1 is “does not affect” and 5 is “severely affects”, rate the following questions:

  1. 1.

    To what extent does your forearm surgery currently affect your work or other regular daily activities?

  2. 2.

    To what extent does your forearm surgery currently affect your normal social activity?

On a scale of 1 to 5, where 1 is “no” and 5 is “severe”, rate the following questions:

  1. 3.

    The severity of pain you currently have in the upper limb on which you had surgery.

  2. 4.

    The severity of tingling you currently have in the upper limb on which you had surgery.

Please answer the following questions yes/no:

  1. 5.

    Does your forearm incision disturb you in any way?

  2. 6.

    Would you prefer a smaller incision? (open group only)

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Medalion, B., Fuks, A., Sharoni, E. et al. Limb performance and patient satisfaction after radial artery harvesting: endoscopic versus open techniques. Surg Endosc 22, 2638–2642 (2008). https://doi.org/10.1007/s00464-008-9777-3

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  • DOI: https://doi.org/10.1007/s00464-008-9777-3

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