Comparison of ultrasonically activated scalpel and traditional technique in radial artery harvesting: clinical research.
BACKGROUND
Use of the radial artery (RA) as a conduit in coronary artery bypass grafting (CABG) has become increasingly popular in recent years. The aim of this study was to compare the results of two different RA harvesting techniques. Use of the harmonic scalpel is suggested to be safe and additionally reduces spasm rates.


METHODS
From January 2000, the first 200 consecutive patients who underwent RA harvesting for CABG were enrolled in this study. Patients were divided into two groups. RA was harvested by means of electrocautery + hemoclips in Group I and by harmonic scalpel + hemoclips in Group II. 30 patients (30 %) in Group I and 25 patients (25 %) in Group II were female. Mean age was 53.9 +/- 9.3 and 53.5 +/- 8.4 years in Group I and Group II, respectively. Hand circulation and ulnar collateral flow was assured with a modified Allen test in all patients preoperatively. During the operation perfusion of the hand was monitored by oximetric plethysmography. The distal end of RA was also explored and clamped with a soft vascular clamp to evaluate the saturation values in the groups. During the clamping period, oxygen saturation values did not decrease so we harvested RAs in all patients.


RESULTS
There were no statistically significant differences between the groups with the exception of the RA harvesting times, the postoperative analgesia requirements, the rate of vasospasm and the need for hemostatic clips.


CONCLUSIONS
Harmonic scalpel usage in RA harvesting causes less trauma to adjacent tissues; the analgesia requirements, the rate of vasospasm, the RA harvesting time and the need of hemostatic clips decreases. We conclude that the use of a harmonic scalpel for radial artery harvesting is safer and faster than the routine technique.
Oz
B S
BS
Department of Cardiovascular Surgery, GATA - Gulhane Military Academy of Medicine, Ankara, Turkey. bsavoz@yahoo.com
Mataraci
I
I
Iyem
H
H
Kuralay
E
E
Doganci
S
S
Demirkilic
U
U
Yokusoglu
M
M
Tatar
H
H
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003097:Collateral Circulation; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D004564:Electrocoagulation / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006225:Hand / Q000098:blood supply / Q000294:innervation; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010991:Plethysmography; D017534:Radial Artery / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D020886:Somatosensory Disorders / Q000209:etiology / Q000503:physiopathology; D013035:Spasm / Q000209:etiology / Q000503:physiopathology; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome; D014457:Ulna / Q000098:blood supply / Q000294:innervation; D014465:Ultrasonics