BACKGROUND: The radial artery was proposed and then abandoned as a coronary artery bypass graft in the 1970s. Development of new pharmacologic antispasmodic agents and minimally traumatic harvesting techniques has led to a revival of the use of the radial artery in coronary artery bypass surgery. Usually the main reasons for the spasm are thermal injury caused by electrocautery and traumatic harvesting technique. METHODS: In our technique an ultrasonically activated scalpel (Harmonic Scalpel; Ultracision Inc, Smithfield, RI) was used for radial artery harvesting without using hemostatic clips for vessel side branches. The patients in the study were divided into two groups of 10 patients each. In the first group radial arteries were harvested with this technique, and in the second group with hemostatic clips, scissors, and minimal electrocautery. Harvesting time, frequency of spasm, and use of hemostatic clips were compared between the two groups. RESULTS: The Harmonic Scalpel decreased the harvesting time, frequency of spasm, and excessive use of hemostatic clips. CONCLUSIONS: Good coagulation capacity with markedly decreased use of hemostatic clips and minimized thermal injury offers the surgeon the ability to perform less traumatic, spasm free, and rapid radial artery harvesting.
BACKGROUND: The radial artery was proposed and then abandoned as a coronary artery bypass graft in the 1970s. Development of new pharmacologic antispasmodic agents and minimally traumatic harvesting techniques has led to a revival of the use of the radial artery in coronary artery bypass surgery. Usually the main reasons for the spasm are thermal injury caused by electrocautery and traumatic harvesting technique. METHODS: In our technique an ultrasonically activated scalpel (Harmonic Scalpel; Ultracision Inc, Smithfield, RI) was used for radial artery harvesting without using hemostatic clips for vessel side branches. The patients in the study were divided into two groups of 10 patients each. In the first group radial arteries were harvested with this technique, and in the second group with hemostatic clips, scissors, and minimal electrocautery. Harvesting time, frequency of spasm, and use of hemostatic clips were compared between the two groups. RESULTS: The Harmonic Scalpel decreased the harvesting time, frequency of spasm, and excessive use of hemostatic clips. CONCLUSIONS: Good coagulation capacity with markedly decreased use of hemostatic clips and minimized thermal injury offers the surgeon the ability to perform less traumatic, spasm free, and rapid radial artery harvesting.
Authors: Nicholas S Burris; Emile N Brown; Michael Grant; Zachary N Kon; Marc Gibber; Junyen Gu; Kimberly Schwartz; Seeta Kallam; Ashish Joshi; Richard Vitali; Robert S Poston Journal: Ann Thorac Surg Date: 2008-04 Impact factor: 4.330