HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Oz M. Shapira Thomas G. Christensen Curtis T. Hunter Harold L. Lazar Richard J. Shemin Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shapira, O. M. Articles by Keaney, J. F. Search for Related Content PubMed PubMed Citation Articles by Shapira, O. M. Articles by Keaney, J. F., Jr Related Collections Minimally invasive surgery

J Thorac Cardiovasc Surg 2006;131:388-394
© 2006 The American Association for Thoracic Surgery

Evolving Technology

Endoscopic versus conventional radial artery harvest for coronary artery bypass grafting: Functional and histologic assessment of the conduit

^a Department of Cardiothoracic Surgery, Boston Medical Center, Boston, Mass
^b Evans Department of Medicine, Boston Medical Center, Boston, Mass
^c Mallory Institute of Pathology, Boston Medical Center, Boston, Mass

Read at the Thirty-first Annual Meeting of The Western Thoracic Surgical Association, Victoria, BC, Canada, June 22-25, 2005.

Received for publication May 11, 2005; revisions received June 28, 2005; accepted for publication July 12, 2005.

^_* Address for reprints: Oz M. Shapira, MD, Department of Cardiothoracic Surgery, Boston Medical Center, 88 East Newton St, Boston, MA 02118 (Email: oz.shapira{at}bmc.org).

BACKGROUND: The radial artery's propensity for vasospasm and vulnerability to surgical trauma are well known. A less invasive endoscopic method to harvest the radial artery was recently introduced, but its effect on radial artery integrity is unknown.

METHODS: To compare the effects of harvest method on radial artery function, we prospectively randomized 54 patients undergoing coronary artery bypass grafting with the radial artery into 3 groups on the basis of harvest techniques: endoscopic, conventional with cautery, and conventional with harmonic scalpel. We assessed endothelium-dependent and endothelium-independent relaxation of radial artery segments to sequential doses of acetylcholine and nitroglycerin, respectively, using standard organ-chamber methodology. Vasospasm was assessed as the vasoconstrictor response to the thromboxane analog U46619. We assessed endothelial integrity using light and electron microscopy and by rating intercellular adhesion molecule 1, vascular cell adhesion molecule 1, and P-selectin expression by means of immunohistochemistry on a semiquantitative 0- to 3-point scale. Harvest procedures were performed by a single surgeon, and data analyses were blinded to the harvesting method.

RESULTS: Maximal relaxation-contraction responses to acetylcholine, nitroglycerin, and U46619 and effective drug concentration yielding 50% response were similar in the 3 groups. Adhesion molecule expression and histologic changes, as assessed by means of light and electron microscopy, were similar in the 3 groups.

CONCLUSIONS: Endoscopic harvest does not alter radial artery vasoreactivity or endothelial integrity compared with conventional harvest techniques. Because the endoscopic technique is less invasive, it might prove to be the technique of choice to harvest the radial artery.

This article has been cited by other articles:

				P. S. Brazio, P. C. Laird, C. Xu, J. Gu, N. S. Burris, E. N. Brown, Z. N. Kon, and R. S. Poston Harmonic scalpel versus electrocautery for harvest of radial artery conduits: Reduced risk of spasm and intimal injury on optical coherence tomography. J. Thorac. Cardiovasc. Surg., November 1, 2008; 136(5): 1302 - 1308. [Abstract] [Full Text] [PDF]

				B. Medalion, A. Tobar, Z. Yosibash, A. Stamler, E. Sharoni, E. Snir, E. Porat, and E. Hochhauser Vasoreactivity and histology of the radial artery: comparison of open versus endoscopic approaches Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 845 - 849. [Abstract] [Full Text] [PDF]

				S. Bleiziffer, I. Hettich, B. Eisenhauer, D. Ruzicka, B. Voss, R. Bauernschmitt, and R. Lange Neurologic sequelae of the donor arm after endoscopic versus conventional radial artery harvesting J. Thorac. Cardiovasc. Surg., September 1, 2008; 136(3): 681 - 687. [Abstract] [Full Text] [PDF]

				J. A. Vita, M. Holbrook, J. Palmisano, S. M. Shenouda, W. B. Chung, N. M. Hamburg, B. R. Eskenazi, L. Joseph, and O. M. Shapira Flow-Induced Arterial Remodeling Relates to Endothelial Function in the Human Forearm Circulation, June 17, 2008; 117(24): 3126 - 3133. [Abstract] [Full Text] [PDF]

				N. S. Burris, E. N. Brown, M. Grant, Z. N. Kon, M. Gibber, J. Gu, K. Schwartz, S. Kallam, A. Joshi, R. Vitali, et al. Optical Coherence Tomography Imaging as a Quality Assurance Tool for Evaluating Endoscopic Harvest of the Radial Artery Ann. Thorac. Surg., April 1, 2008; 85(4): 1271 - 1277. [Abstract] [Full Text] [PDF]

				S. Bleiziffer, I. Hettich, B. Eisenhauer, D. Ruzicka, M. Wottke, J. Hausleiter, S. Martinoff, M. Morgenstern, and R. Lange Patency rates of endoscopically harvested radial arteries one year after coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 649 - 656. [Abstract] [Full Text] [PDF]