clinical update publication

Radial Artery Provides Reliable Conduit Option
Deborah Offers Nonsurgical Treatment for ASD

radial artery

Radial Artery Provides Reliable Conduit Option

Since 1996, Deborah Heart and Lung Center surgeons have, during coronary artery bypass graft (CABG) surgery, turned to the radial artery for a reliable, durable conduit option. William Anderson, MD, Attending Cardiothoracic Surgeon, and his team at Deborah, have found success using the radial artery, and other Deborah Heart and Lung Center surgeons have added the radial artery to their armamentarium.

Use of the radial artery as a conduit during CABG was examined, then abandoned, during the 1970s, as the radial artery was found to be subject to spasm as well as being associated with complications resulting in ischemia of the hand. Since then, the administration of calcium channel blockers to prevent spasm and the development of less traumatic harvesting techniques have led to the reexamination of this reliable conduit.

Dr. Anderson and his surgical team began using the radial artery in 1996, performing 98 harvests in 72 patients between November 1996 and July 1998. Immediate results of the procedure were encouraging: patients ambulated quickly, reported little or no wound pain and no wound infections occurred. But some early data showed isolated cases of narrowing in the radials that were implanted. This warranted further investigation and insight into its etiology. Deductive reasoning suggested a relationship between the time the artery spent ex-vivo and the isolated events of narrowing in the post-operative period. Therefore, Dr. Anderson and his team developed techniques that have eliminated the ex-vivo time of the radial artery, thus preventing the development of ischemia in the arterial wall.

“Realizing that the radial artery is sensitive to ischemia ex-vivo, when harvesting the radial artery, Deborah surgeons limit ex-vivo time to five minutes or less,” said Dr. Anderson. “The artery is transferred directly to the chest upon harvest, and is immediately pulsating in circulation. This treatment of the radial artery as a living conduit has maximized patency rates of radial grafts at Deborah.”

Radial Artery surgery

Especially useful for patients who have limited conduit options because of previous bypass surgery or whose saphenous veins are undesirable, the radial artery provides physicians with a reliable conduit choice, as the radial artery is more uniform in size and characteristic. Also, the long-term patency of arterial conduits is much greater than that for veins, because the arterial wall is less prone to atherosclerosis. Another plus has been the decrease in morbidity associated with the location of the radial artery harvest site. One of the more persistent problems associated with CABG is harvest site morbidity, especially from the leg incisions. According to Dr. Anderson, patients complain more about pain related to leg incisions than chest incisions. There are also problems related to infection. Leg complications discourage ambulation, which in turn delays overall healing and recovery as many patients are forced to remain in bed with painful leg infections.

At the time of this writing, 488 patients had undergone 763 radial artery harvests, and no wound infections occurred. Additionally, patients consistently report minimal discomfort associated with the incision in their arms and have full function of their arms and hands immediately after surgery.

“Realizing that the radial artery is sensitive to ischemia ex-vivo, when harvesting the radial artery, Deborah surgeons limit ex-vivo time to five minutes or less,” said Dr. Anderson. “The artery is transferred directly to the chest upon harvest, and is immediately pulsating in circulation. This treatment of the radial artery as a living conduit has maximized patency rates of radial grafts at Deborah.”
Especially useful for patients who have limited conduit options because of previous bypass surgery or whose saphenous veins are undesirable, the radial artery provides physicians with a reliable conduit choice, as the radial artery is more uniform in size and characteristic. Also, the long-term patency of arterial conduits is much greater than that for veins, because the arterial wall is less prone to atherosclerosis. Another plus has been the decrease in morbidity associated with the location of the radial artery harvest site. One of the more persistent problems associated with CABG is harvest site morbidity, especially from the leg incisions. According to Dr. Anderson, patients complain more about pain related to leg incisions than chest incisions. There are also problems related to infection. Leg complications discourage ambulation, which in turn delays overall healing and recovery as many patients are forced to remain in bed with painful leg infections

The radial artery has become a viable option at Deborah Heart and Lung Center because of the long-term patency and minimal harvest site morbidity it offers, especially in patients who may not have a viable saphenous vein. “I feel that Deborah surgeons have refined radial artery harvesting to a point where the procedure is extremely successful,” said Dr. Anderson. “It is satisfying to provide this to patients, especially those without other viable graft options. We are able, with this procedure, to provide them with a little something more.”

Radial Artery harvesting

William Anderson, MD., Attending, Department of Surgery

Return to Home l Cardiac Services l Pulmonary Services l Patient Information l Support Groups l Directions

Are You Interested in Being Contacted for an Appointment?
Questions? send your e-mail to
askaquestion@deborah.org