Can ulnar artery velocity changes be used as a preoperative screening tool for radial artery grafting in coronary artery bypass?
Radial artery harvesting for coronary revascularization may result in digit ischemia if collateral circulation is inadequate. The purpose of this study was to compare changes in ulnar artery flow velocity during radial artery compression (RAC) with changes in first- and second-digit pressures during RAC, a previously validated predictor of digital ischemia. Photoplethysmography was used to measure first- and second-digit arterial pressures before and during RAC on 80 extremities. Color flow duplex imaging was used to measure distal ulnar artery peak systolic velocity before and during RAC. Seventy-eight of eighty extremities had a slight increase in ulnar artery velocity with RAC. There was no correlation between ulnar artery velocity changes and digit pressure changes. Measurement of ulnar artery velocity during RAC is not a useful predictor of digit pressure changes. Measurement of segmental upper extremity pressures with first- and second-digit pressure measurement during radial artery compression should remain the preferred preoperative screening tool for radial artery harvest prior to CABG.
Sullivan
V V
VV
Section of Vascular Surgery, Department of Surgery, Michigan Heart and Vascular Institute, St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA.
Higgenbotham
C
C
Shanley
C J
CJ
Fowler
J
J
Lampman
R M
RM
Whitehouse
W M
WM
Wolk
S W
SW
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D017534:Radial Artery / Q000000981:diagnostic imaging; D020858:Tissue and Organ Harvesting / Q000379:methods; D017535:Ulnar Artery / Q000000981:diagnostic imaging* / Q000502:physiology; D018615:Ultrasonography, Doppler, Color