Should the internal thoracic artery be skeletonized?
Traditionally, the internal thoracic artery is harvested as a pedicle. In contemporary cardiac surgical practice, however, certain surgeons practice the internal thoracic artery-skeletonization technique. A systematic review of clinical studies reporting on the use of skeletonized internal thoracic arteries (SKT-ITA) has not yet been performed. The primary aim of this review article is to examine comprehensively the entire body of evidence regarding the use of SKT-ITA. In particular, we aimed to analyze the effects of skeletonization on sternal blood supply, wall damage and blood flow in the harvested vessel, postoperative graft patency, and clinical outcome. Advantages and disadvantages of the skeletonization technique are highlighted and discussed.
Athanasiou
Thanos
T
The National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Department of Cardiothoracic Surgery, St Mary's Hospital, London, United Kingdom. tathan5253@aol.com
Crossman
Mary-Clare
MC
Asimakopoulos
George
G
Cherian
Ashok
A
Weerasinghe
Arjuna
A
Glenville
Brian
B
Casula
Roberto
R
D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D008323:Mammary Arteries / Q000637:transplantation*; D011183:Postoperative Complications; D020858:Tissue and Organ Harvesting / Q000379:methods; D014654:Vascular Patency