Effect of radial artery harvest on collateral forearm blood flow and digital perfusion.
BACKGROUND
Changes describing digital and forearm circulation after radial artery harvest have been reported infrequently.


METHODS
This prospective study examined digital perfusion and forearm collateral circulation preoperatively and postoperatively in patients who underwent coronary artery bypass grafting with radial artery free grafts. Noninvasive evaluation was conducted with digital photoelectric plethysmography and color flow and pulsed Doppler studies.


RESULTS
Thumb perfusion index decreased from 1.25 to 0.84 (30%, P <.001) in the unoperated extremities and from 1.23 to 0.80 (36%) in the operated extremities (P <.001). Doppler studies in extremities after radial artery harvest demonstrated an increase in ulnar artery diameter from 3.87 to 4.66 mm (15.7%, P <.001) and a rise in ulnar blood flow velocity from 38.96 to 48.46 cm/s (17.4%) preoperatively to 8 weeks postoperatively (P <.001). No hand ischemia was noted.


CONCLUSIONS
Our study identified a mild reduction in digital perfusion and an increase in ulnar artery flow velocity and diameter with no clinical sequelae or compromise in hand function after radial artery harvest in properly selected patients.
Brodman
Richard F
RF
Department of Cardiothorcic Surgery, Joan and Sanford I. Weill Medical College of Cornell University, New York-Presbyterian Hospital, 525 East 68th Street, New York, NY 10021, USA. rfb20002@mail.med.cornell.edu
Hirsh
Laurie E
LE
Frame
Rosemary
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003097:Collateral Circulation; D001026:Coronary Artery Bypass; D005260:Female; D005385:Fingers / Q000098:blood supply*; D005542:Forearm / Q000098:blood supply*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery / Q000637:transplantation*; D012039:Regional Blood Flow; D013048:Specimen Handling; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000502:physiology; D018617:Ultrasonography, Doppler, Pulsed