101. Safe removal of the radial artery for myocardial revascularization: a Doppler study to prevent ischemic complications to the hand
- Author
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Roberto Flore, Angela Favuzzi, Eric Manasse, Paolo Pola, Michele Serricchio, and Gian Federico Possati
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Ischemia ,Subclavian Artery ,Hemodynamics ,Collateral Circulation ,Arterial Occlusive Diseases ,Constriction, Pathologic ,Allen's test ,Ulnar Artery ,medicine.artery ,Internal medicine ,Preoperative Care ,medicine ,Humans ,Derivation ,Radial artery ,Coronary Artery Bypass ,Subclavian artery ,Ulnar artery ,Vascular Patency ,Aged ,business.industry ,Contraindications ,Patient Selection ,Ultrasonography, Doppler ,Middle Aged ,medicine.disease ,Hand ,Surgery ,Stenosis ,Regional Blood Flow ,Radial Artery ,Cardiology ,Female ,Safety ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity ,Follow-Up Studies - Abstract
Radial artery harvesting has recently been reintroduced for myocardial revascularization. Harvesting the radial artery may jeopardize the vascularization of the hand; cautious selection of candidates must therefore be pursued. The study involved 188 consecutive patients. We verified the patency of the upper limb's arteries and the adequacy of the ulnar supply by static and dynamic Doppler evaluations. The use of the radial artery was contraindicated in 14 cases (three for stenosis of the subclavian artery and 11 for inadequate collateralization). One hundred patients were operated on with the radial artery used as a graft; the remaining 74 patients had a different conduit placed. The vascularization of the hand was restudied within 10 days in all patients who underwent operation; in 63 patients, it was studied again at 1 year. The early Doppler examination showed significant increase in blood flow velocities in the ulnar artery, with a flow redistribution in the common digital palmar arteries (decreased in the first and increased in the second and the third). The late Doppler examination showed superimposable findings. No local ischemic complications were observed. We conclude that Doppler study is a useful tool in preoperative screening of candidates for radial artery harvesting for myocardial revascularization. (J THORAC CARDIOVASC SURG 1996;112:737-44)
- Published
- 1996