title: Comparison of harmonic scalpel and high-frequency electrocautery in radial artery harvesting.
abstract: OBJECTIVE
  We evaluated the effects of the radial artery on the functional outcomes and endothelium when the harvest was made either by harmonic scalpel or by high-frequency electrocautery.
  
  
  METHODS
  Between 2002 and 2007, 982 patients with coronary artery diseases were operated for coronary artery revascularization. The radial arteries were harvested for 101 of these patients and divided into two groups depending on the use of the harmonic scalpel (Group A; N=51) and the high-frequency electrocautery (Group B; N=50). Harvesting time, use of hemostatic clips, frequency of spasm, in situ free flow, and endothelial damage were compared between the two groups.
  
  
  RESULTS
  Conventional high-frequency electrocautery technique used 8.7+/-3.9 hemostatic clips versus 1.5+/-1 clips (P<0.001). In situ free blood flow was 85+/-5.5 mL/min for Group B versus 114+/-21.7 mL/min for Group A (P<0.006). The endothelial damage of the radial arteries taken down with the harmonic scalpel was significantly less than when taken down with the high-frequency electrocautery (P<0.05). There was no statistically significant difference in terms of harvesting time and spasm between the two groups (P>0.05).
  
  
  CONCLUSIONS
  Ultrasonic dissection with harmonic scalpel of the radial artery is associated with a decreased use of hemostatic clips. Moreover, the harmonic scalpel has a positive effect on endothelial preservation and it was associated with increased free blood flow of the radial artery.
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey. erkut.bilgehan@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: Erkut
authors.forename: Y
authors.initials: Y
authors.lastname: Unlu
authors.forename: S
authors.initials: S
authors.lastname: Karapolat
authors.forename: C
authors.initials: C
authors.lastname: Ugur Kocogullari
authors.forename: M
authors.initials: M
authors.lastname: Ceviz
authors.forename: N
authors.initials: N
authors.lastname: Becit
authors.forename: H
authors.initials: H
authors.lastname: Kocak
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D004210:Dissection / Q000295:instrumentation; D004564:Electrocoagulation / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017534:Radial Artery / Q000601:surgery* / Q000637:transplantation; D020858:Tissue and Organ Harvesting / Q000295:instrumentation*; D014465:Ultrasonics