Original ArticlesEasy Harvesting of Radial Artery With Ultrasonically Activated Scalpel
Section snippets
Study Groups
In this study we harvested 20 radial arteries for coronary artery bypass grafting. We divided the patients into two equal groups. In the first group, radial arteries were harvested using the Harmonic Scalpel, and in the second group, hemostatic clips, scissors, and minimal electrocautery were used. The two groups were compared for harvesting time (the time spent between the radial artery skin incision and being fully prepared for anastomosis), frequency of spasm (the disappearance of visible
Results
Use of the Harmonic Scalpel decreased the harvesting time of the radial artery, frequency of spasm, and use of hemostatic clips (Table 1). The markedly decreased need to use hemostatic clips for side branches provided less traumatic, fast, spasm-free harvesting and easy handling during anastomosis. There was no need in any case to place additional hemostatic clips on the radial artery after it had been placed on the heart.
Comment
Arterial graft spasm is one of the most important issues in coronary artery bypass surgery. Usually it occurs during the graft harvesting. The main causes are surgical technique and thermal injury because of electrocautery [3]. Also, patency of the arterial graft may be jeopardized by the thermal injury.
This ultrasonically activated scalpel causes minimal thermal injury, and satisfactory coagulation eliminates the need to use hemoclips for side branches 4, 5. Harvesting technique without using
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Cited by (55)
Antispastic Management in Arterial Grafts in Coronary Artery Bypass Grafting Surgery
2016, Annals of Thoracic SurgeryCitation Excerpt :Vasospasm may involve thermal injury caused by electrocautery and traumatic harvesting technique. The ultrasonic scalpel was proposed to decrease harvesting time, frequency of spasm, and excessive use of hemostatic clips [75], and the technique has rapidly spread. Pratt and colleagues [76] reported that intractable left IMA spasm after CABG was successfully managed with a left main stent.
Radial artery as graft for coronary artery bypass surgery: Advantages and disadvantages for its usage focused on structural and biological characteristics
2014, Journal of CardiologyCitation Excerpt :Harvesting the RA with the accompanying veins and fat, minimal handling of the graft, limited use of electrocautery, and avoiding probing or hydrostatic dilation of the conduit are some important clues [33]. Psacioglu et al. [36] introduced in 1998 a modified RA harvesting technique. Using an ultrasonically activated scalpel and without clipping the vessel side branches, they managed to improve the harvesting time, the frequency of spasm, and the trauma [36].
Use of an ultrasonic blade facilitates muscle repair after incision injury
2011, Journal of Surgical ResearchOptical Coherence Tomography Imaging as a Quality Assurance Tool for Evaluating Endoscopic Harvest of the Radial Artery
2008, Annals of Thoracic SurgeryDoes harvesting of an internal thoracic artery with an ultrasonic scalpel have an effect on sternal perfusion?
2007, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :It is still early to make a final decision, and the effect of skeletonization on sternal perfusion needs to be evaluated by further randomized studies with larger numbers of patents with well-defined time points. The harvest of arterial conduits with the USS21,24,25 has been a relatively novel concept for less than a decade. Concurrently, the effects of ultrasonic dissection on arterial conduits have been evaluated using morphologic and physiologic properties by several authors.23,26,27
Endoscopic versus conventional radial artery harvest for coronary artery bypass grafting: Functional and histologic assessment of the conduit
2006, Journal of Thoracic and Cardiovascular Surgery