Our experience in endoscopic radial artery harvesting

Objectives: Technological advancements make possible the endoscopic radial artery harvesting, a less traumatic technique for the tissues and the same artery, as our experience demonstrates. Methods: From November 2003 to May 2004 we harvested 21 left radial arteries with endoscopic technique. We used the Ethicon Cardiovations Vessel Harvesting System ClearglideTM . The vessel was accessed through a 3 cm long, longitudinal skin incision performed several millimeters medial to the palpated artery. A further 2.5 cm long transversal skin incision was performed for the proximal section of the artery in 11 cases; in the remaining 10 cases (47.6%) we used the Ethicon Endoloop PDS II , without wrist skin incision. In 7 cases we used Ethicon Dermabond glue in place of usual intradermic suture. Histological analysis was performed on surgical specimens of radial arteries harvested endoscopically or with a traditional surgical approach, to compare wall artery damages caused by both techniques. Radial artery grafts patency rate has been estimated with multislice CT Scan. Results: All endoscopic harvested radial arteries have been used as bypass grafts. During the procedure, rupture of a radial artery collateral branch occurred in 3 patients (14.2%); only in 1 case of them it was necessary use a second endoloop, without any necessity of surgical conversion. Only in 1 case a subcutaneous haematoma took place without necessity of surgical drainage. In the majority of patients we observed transitory disestesia reverted in the follow up. Infections of the wounds have not been observed. We will discuss in the congress session the results of the histological analysis and instrumental CT scan follow up. Conclusions: Endoscopic technique could be a safe, reproducible method for the radial artery harvesting, with excellent cosmetics results for the patients. Multislice CT Scan could represent an effective instrument to study the patency rate of radial artery grafts.