Radial Artery harvesting for bypass surgery

In summary, the article states that there is an increase in the risk of pour tissue oxygenation when performing radial artery harvesting, and that this risk is also likely to increase in the case of ulnar artery harvesting. However, the radial artery is still a preferable option over the ulnar artery when it comes to coronary bypass surgery.
  • #1
Charles123
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Radial Artery harvesting is becoming and more and more used as an option for bypass surgery. I have read that there is an increase in the risk of pour tissue oxygenation, which of course makes sense. You can read more in - http://lib.tmd.ac.jp/jmd/5202/01_manabe.pdf, where it is also referred that there is an also logical increase in flow in the Ulnar Artery.
In terms of the hand I can see that one can compensate the other. But in the forearm, Isn`t the Radial Artery of extreme importance? The article does not mention vasculogenesis, neither I found anything related to it, but doesn’t it play a great role in the recovery here?

Thank you

Regards
 
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  • #2
Charles123 said:
Radial Artery harvesting is becoming and more and more used as an option for bypass surgery. I have read that there is an increase in the risk of pour tissue oxygenation, which of course makes sense. You can read more in - http://lib.tmd.ac.jp/jmd/5202/01_manabe.pdf, where it is also referred that there is an also logical increase in flow in the Ulnar Artery.
In terms of the hand I can see that one can compensate the other. But in the forearm, Isn`t the Radial Artery of extreme importance? The article does not mention vasculogenesis, neither I found anything related to it, but doesn’t it play a great role in the recovery here?

Thank you

Regards

The simple fact is that there are not too many places to safely obtain autografts for coronary revascularization. They tend to be needed where they are. The short internal thoracic (mammary) arteries are preferred for single grafts but many surgeries require the graft to be cut into a number of pieces for multiple locations. In general any arterial graft is superior to a venous one.

That leaves the radial artery where about 20 cm can be taken. The ulnar artery can ordinarily be relied on to supply the affected area. Oxygen demand is much less in the upper extremity as compared to the lower. It's not ideal, but neither is having to have bypass grafts in your heart. The radial artery requires very expert handling because it is easily damaged and tends to go into spasm. The following article summarizes some of the pros and cons in addition to the points made in the the link you posted.

http://circ.ahajournals.org/content/110/5/e40.full

I'm not sure what you mean by vasculogenesis. The heart itself is capable of developing collateral circulation to circumvent smaller blocked arteries, but it may or may not stay ahead of the atherosclerotic process. You probably haven't heard of it because it's not clear that we can do it better than the heart can.

www.molmed.org/content/1998/7_98/Rivard.pdf [Broken]
 
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  • #3
Yeah Let me add that atherosclerosis and sternosis and even the overall long term compliance of the vessels are the main factors to be concerned for long term morbidity and mortality. Vasculogenesis is not reliable enough, especially trying to work with a damaged heart whose ejection fraction maybe not be high in the first place
 
  • #4
mazinse said:
Yeah Let me add that atherosclerosis and sternosis and even the overall long term compliance of the vessels are the main factors to be concerned for long term morbidity and mortality. Vasculogenesis is not reliable enough, especially trying to work with a damaged heart whose ejection fraction maybe not be high in the first place
Hi mazinse, as you have probably noted, people add links to mainstream journals, articles, etc... that back up what they say and allow people to read and verify what is posted.

Please start adding sources for specific information as posted above, it is very helpful to everyone trying to get a better understanding of the subject.

Thanks.
 
  • #5
,

I appreciate your interest in the use of radial artery harvesting for bypass surgery. It is indeed a topic that has been gaining more attention in recent years. The article you referenced does mention the potential risk of poor tissue oxygenation in the radial artery, which is a valid concern. However, it is important to note that this risk can be mitigated by proper surgical techniques and post-operative care.

In terms of the ulnar artery, it is true that it can compensate for the reduced flow in the radial artery. However, it is important to carefully assess the condition of the ulnar artery before using it as a substitute. The ulnar artery may not always be a suitable alternative, especially in cases where it is already compromised due to preexisting conditions.

Regarding vasculogenesis, while it is a crucial process in tissue repair and regeneration, its role in the recovery of the radial artery after harvesting is not well understood. More research is needed to fully understand the impact of vasculogenesis in this context.

In conclusion, while there are potential risks associated with radial artery harvesting for bypass surgery, it can still be a viable option when performed carefully and with proper post-operative care. Further research is needed to better understand the role of vasculogenesis in the recovery process. Thank you for bringing up this important topic and I hope my response has been helpful.
 

1. What is radial artery harvesting for bypass surgery?

Radial artery harvesting is a surgical procedure in which the radial artery, located in the forearm, is removed and used as a graft in coronary artery bypass surgery. This means that the artery is taken from one part of the body and used to bypass a blockage in another artery to improve blood flow to the heart.

2. How is the radial artery harvested?

The radial artery is usually harvested from the non-dominant arm, as it is less essential for daily activities. The surgery is performed under general anesthesia, and a small incision is made in the forearm to access the artery. The artery is then carefully removed, and the incision is closed with sutures.

3. What are the benefits of using the radial artery for bypass surgery?

The radial artery is a smaller, more flexible artery compared to other graft options, such as the saphenous vein. This allows for easier and more precise placement in the coronary arteries, resulting in better long-term outcomes. Additionally, the radial artery may have a lower risk of developing blockages compared to other grafts.

4. What are the potential risks or complications of radial artery harvesting?

As with any surgical procedure, there are potential risks and complications associated with radial artery harvesting. These may include infection, bleeding, nerve damage, and scarring at the incision site. There is also a small risk of developing hand or wrist pain or weakness, although this is rare.

5. How long does it take to recover from radial artery harvesting for bypass surgery?

The recovery time can vary for each individual, but most patients can expect to spend 1-2 days in the hospital following the surgery. It may take several weeks for the incision to fully heal, and patients are advised to avoid heavy lifting or strenuous activities during this time. Physical therapy may also be recommended to help regain strength and range of motion in the arm.

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