HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): James T. Diehl Richard N. Edie John D. Mannion Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rodriguez, E. Articles by Mannion, J. D. Search for Related Content PubMed PubMed Citation Articles by Rodriguez, E. Articles by Mannion, J. D. Related Collections Coronary disease

Eur J Cardiothorac Surg 2001;19:135-139
© 2001 Elsevier Science NL

The role of preoperative radial artery ultrasound and digital plethysmography prior to coronary artery bypass grafting

Department of Cardiothoracic Surgery, Jefferson Medical College, Suite 607, 1025 Walnut Street, Philadelphia, PA 19107, USA

Received 5 May 2000; received in revised form 23 October 2000; accepted 17 November 2000.

Corresponding author. Tel.: +1-215-955-5095; fax: +1-215-955-6010
e-mail: john.mannion{at}mail.tju.edu

Objective: Doppler ultrasound and digital plethysmography are used at our institution to determine the suitability of the radial artery for harvest prior to coronary artery bypass grafting (CABG). The purpose of this study is to determine the value of this preoperative evaluation. Methods: A retrospective analysis of non-invasive radial artery testing was performed on 187 CABG patients. Criteria used to exclude radial arteries from harvest were anatomic abnormalities (size<2 mm, diffuse calcifications), and perfusion deficits during radial artery occlusion (>40% reduction in digital pressure, non-reversal of radial artery flow, or minimal increase in ulnar velocity). A questionnaire was used to determine the incidence of postoperative hand ischemia or rehabilitation. Results: In 187 patients, 346 arms were evaluated. Ninety-four arms (27.1%) were excluded for harvesting. Anatomical abnormalities included size<2 mm (1.5%), diffuse calcifications (8.7%), congenital anomalies (2.3%), and radial artery occlusion (0.3%). Circulatory abnormalities included non-reversal of flow (7.2%), abnormal digital pressures (5.5%), and inappropriate increase in ulnar velocity (1.7%). A total of 116 radial arteries were harvested. There were no episodes of hand ischemia. No patient required hand rehabilitation. Conclusions: Doppler ultrasound and digital plethysmography identifies both perfusion (14.5%) and anatomical (12.7%) abnormalities that may make the radial artery less suitable as a bypass conduit.

Key Words: Ultrasound • Plethysmography • Radial artery • Coronary artery bypass grafting

This article has been cited by other articles:

				M. Brzezinski, T. Luisetti, and M. J. London Radial Artery Cannulation: A Comprehensive Review of Recent Anatomic and Physiologic Investigations Anesth. Analg., December 1, 2009; 109(6): 1763 - 1781. [Abstract] [Full Text] [PDF]

				M. Kohonen, O. Teerenhovi, T. Terho, J. Laurikka, and M. Tarkka Non-harvestable radial artery. A bilateral problem? Interactive CardioVascular and Thoracic Surgery, October 1, 2008; 7(5): 797 - 800. [Abstract] [Full Text] [PDF]

				P. M. Vukovic, S. S. Radak, M. S. Peric, D. G. NeSic, and A. M. KneSevic Radial Artery Harvesting for Coronary Artery Bypass Grafting: A Stepwise-Made Decision Ann. Thorac. Surg., September 1, 2008; 86(3): 828 - 831. [Abstract] [Full Text] [PDF]

				S. J. Durham and J. P. Gold Late Complications of Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 535 - 548. [Full Text]

				M. Kohonen, O. Teerenhovi, T. Terho, J. Laurikka, and M. Tarkka Is the Allen test reliable enough? Eur. J. Cardiothorac. Surg., December 1, 2007; 32(6): 902 - 905. [Abstract] [Full Text] [PDF]

				Y. J. Loh, M. Nakao, W. D. Tan, C. H. Lim, Y. S. Tan, and Y. L. Chua Factors Influencing Radial Artery Size Asian Cardiovasc Thorac Ann, August 1, 2007; 15(4): 324 - 326. [Abstract] [Full Text] [PDF]

				S. S. Shah, J. R. Sadaba, T. J.P. Batchelor, P. Coughlin, M. T. Burniston, M. Barnfield, and C. M. Munsch Tissue perfusion in non-donor and donor forearm/hand after radial artery harvest: 1- and 5-year follow-up Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 353 - 355. [Abstract] [Full Text] [PDF]

				M. J. Greenwood, A. J. Della-Siega, E. B. Fretz, D. Kinloch, P. Klinke, R. Mildenberger, M. B. Williams, and D. Hilton Vascular Communications of the Hand in Patients Being Considered for Transradial Coronary Angiography: Is the Allen's Test Accurate? J. Am. Coll. Cardiol., December 6, 2005; 46(11): 2013 - 2017. [Abstract] [Full Text] [PDF]

				A. Ronald, A. Patel, and J. Dunning Is the Allen's test adequate to safely confirm that a radial artery may be harvested for coronary arterial bypass grafting? Interactive CardioVascular and Thoracic Surgery, August 1, 2005; 4(4): 332 - 340. [Abstract] [Full Text] [PDF]

				M. Gaudino, M. Serricchio, P. Tondi, L. Gerardino, A. D. Giorgio, P. Pola, and G. Possati Chronic compensatory increase in ulnar flow and accelerated atherosclerosis after radial artery removal for coronary artery bypass J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 9 - 12. [Abstract] [Full Text] [PDF]

				A. Oshima, S. Takeshita, K. Kozuma, N. Yokoyama, K. Motoyoshi, S. Ishikawa, M. Honda, K. Oga, M. Ochiai, and T. Isshiki Intravascular Ultrasound Analysis of the Radial Artery for Coronary Artery Bypass Grafting Ann. Thorac. Surg., January 1, 2005; 79(1): 99 - 103. [Abstract] [Full Text] [PDF]

				H.-S. Lee, Y. J. Heo, and B.-C. Chang Long-term digital blood flow after radial artery harvesting for coronary artery bypass grafting Eur. J. Cardiothorac. Surg., January 1, 2005; 27(1): 99 - 103. [Abstract] [Full Text] [PDF]

				A. G. Royse, C. F. Royse, A. Maleskar, and A. Garg Harvest of the radial artery for coronary artery surgery preserves maximal blood flow of the forearm Ann. Thorac. Surg., August 1, 2004; 78(2): 539 - 542. [Abstract] [Full Text] [PDF]

				H.-S. Lee, B.-C. Chang, and Y. J. Heo Digital blood flow after radial artery harvest for coronary artery bypass grafting Ann. Thorac. Surg., June 1, 2004; 77(6): 2071 - 2074. [Abstract] [Full Text] [PDF]

				Y. Abu-Omar, S. Mussa, K. Anastasiadis, S. Steel, L. Hands, and D. P. Taggart Duplex ultrasonography predicts safety of radial artery harvest in the presence of an abnormal Allen test Ann. Thorac. Surg., January 1, 2004; 77(1): 116 - 119. [Abstract] [Full Text] [PDF]

				H. Sakaguchi, R. Kunitomo, S. Tsurusaki, and M. Kawasuji Coronary artery bypass grafting using a bifurcating radial artery Interactive CardioVascular and Thoracic Surgery, December 1, 2003; 2(4): 563 - 564. [Abstract] [Full Text] [PDF]

				K. Kochi, K. Orihashi, and T. Sueda The snuffbox technique: A reliable color Doppler method to assess hand circulation J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 821 - 825. [Abstract] [Full Text] [PDF]

				I. Birdi and A. J. Ritchie Intraoperative confirmation of ulnar collateral blood flow during radial artery harvesting using the "squirt test" Ann. Thorac. Surg., July 1, 2002; 74(1): 271 - 272. [Abstract] [Full Text] [PDF]

				R. F. Brodman, L. E. Hirsh, and R. Frame Effect of radial artery harvest on collateral forearm blood flow and digital perfusion J. Thorac. Cardiovasc. Surg., March 1, 2002; 123(3): 512 - 516. [Abstract] [Full Text] [PDF]