The pneumatic tourniquet technique for endoscopic radial artery harvest.
BACKGROUND
Endoscopic vessel harvest is viewed as a safe, reliable, and cost-effective method for greater saphenous vein removal. As the radial artery has more recently become a popular conduit choice in coronary artery revascularization, we describe herein an endoscopic technique for radial artery harvest in our first 50 patients as an alternative to the more traditional open technique.


METHODS
From November 2001 to July 2002, 54 radial arteries were harvested endoscopically in 50 patients utilizing the VasoView Endoscopic Vessel Harvesting System, an Esmark bandage, and a pneumatic cuff tourniquet.


RESULTS
No patients experienced symptoms of vascular compromise, or signs of infection in the donor arm. No adjunctive procedures were required during the vessel harvest, i.e., conversion to open technique. All radial arteries were successfully removed with endoscopic technique and 53 of the 54 radial arteries were successfully used as bypass conduits. Although the quality of the radial artery harvested remains subjective, we found less vasospasm than in our experience with the open technique. Thirty-day follow-up revealed no readmissions, no cardiac ischemic complications, no significant complications with the donor arm, and an excellent cosmetic result.


CONCLUSIONS
Endoscopic harvest of the radial artery with the tourniquet technique may offer advantages over the more traditional open technique.
Miles
Ronald H
RH
Wausau Heart Institute, Wausau Community Hospital, Wausau, Wisconsin, USA. jimzo@waushosp.org
Kollpainter
Robert E
RE
Riveron
Fernando A
FA
Johnkoski
John A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017546:Angioscopy / Q000009:adverse effects / Q000379:methods; D001132:Arm / Q000098:blood supply*; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D014111:Tourniquets / Q000009:adverse effects; D016896:Treatment Outcome