Radial artery harvest technique, use and functional outcome1

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Abstract
Objective: To develop a simple harvest technique for radial artery (RA). To investigate the morbidity and functional outcome of RA harvest. Methods: The neurovascular fascia surrounding the RA is divided. Only loose areolar tissue surrounds this artery making harvest of RA simple and allowing minimal trauma to the RA and surrounding muscles. Topical and intraluminal vasodilators but no systemic vasodilators are used. Results: RA harvest commenced in December 1994. Between 1996 and 30 June 1998, 2167 RA were harvested and used to construct 3105 coronary anastomoses. A dramatic rise in RA use occurred during 1996. More than 80% of patients undergoing coronary artery bypass surgery (CABG) have RA harvested since this time. Total arterial revascularization rate also rose dramatically and is currently 80% of all CABG. This rate has been assisted by a rapid rise in the use of composite arterial grafting where aortic anastomoses can be avoided and currently represents 40% of all CABG. Hand strength was tested in 328 non-selected patients and was not reduced by RA harvest when hand dominance was taken into account. Objective sensation loss was present in 0.3% for the superficial radial nerve and 2.1% for the lateral cutaneous nerve of forearm. Pulse oximetry observations detected statistically significant but clinically irrelevant differences. Scar hypersensitivity occurred in 20%. Only two patients of all patients undergoing RA harvest reported late hand ischaemia. Conclusions: Harvest of the RA within the neurovascular plane is simple and associated with low morbidity.