Thorac Cardiovasc Surg 2008; 56(1): 24-27
DOI: 10.1055/s-2007-965577
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Effect of Low Dose Electrocautery Usage during Radial Artery Harvesting on the Neurological Outcome of the Forearm: A Neuroelectrophysiological Study

Ö. Kandemir1 , M. Buyukates1 , U. Emre2 , E. Aktunc3 , S. A. Turan1 , E. Ceylan1 , T. Kurt1
  • 1Department of Cardiovascular Surgery, Zonguldak Karaelmas University, Medical Faculty, Zonguldak, Turkey
  • 2Department of Neurology, Zonguldak Karaelmas University, Medical Faculty, Zonguldak, Turkey
  • 3Department of Family Medicine, Zonguldak Karaelmas University, Medical Faculty, Zonguldak, Turkey
Further Information

Publication History

received April 17, 2007

Publication Date:
17 January 2008 (online)

Abstract

Background: The present study aimed to investigate whether electrocautery caused any thermal injury to the forearm nerves or not. Methods: We compared the neurological outcome of two different radial artery harvesting techniques through neuroelectrophysiological studies. Preoperative values and postoperative conduction changes after one month were compared in two groups of patients. Each of the groups consisted of 20 patients. Radial arteries were harvested using scissors in Group 1 and with a low dose diathermy technique in Group 2. Results: The mean amplitude of sensory action potentials of radial nerves was significantly reduced postoperatively at the end of the first month in both groups (p = 0.01, p = 0.001). But there were no significant differences between groups with respect to the sensory action potentials of ulnar and median nerves postoperatively. There were no significant differences between groups with respect to radial, ulnar and median nerve motor conduction recordings. Conclusion: Low dose electrocautery does not cause excessive nerve injury compared with the scissors technique in radial artery harvesting. Electrocautery may be used safely for RA harvesting in the forearm.

References

  • 1 Carpentier A, Guermonprez J L, Deloche A, Frechette C, DuBost C. The aorta-to-coronary radial artery bypass graft. A technique avoiding pathological changes in grafts.  Ann Thorac Surg. 1973;  16 111-121
  • 2 Acar C, Jebera V A, Portoghese M. et al . Revival of the radial artery for coronary artery bypass grafting.  Ann Thorac Surg. 1992;  54 652-659
  • 3 Moon M R, Barner H B, Bailey M S. et al . Long-term neurologic hand complication after radial artery harvesting using conventional cold and harmonic scalpel techniques.  Ann Thorac Surg. 2004;  78 535-538
  • 4 Reyes G, Traba A, Lopez L, Pinto A, Duarte J, Vallejo J L. Neurologic damage after radial artery harvesting in coronary surgery: a direct measure.  Interact Cardiovasc Thorac Surg. 2006;  5 433-438
  • 5 Dogan O V, Duzgun C, Özeren M. et al . Subclinical injury to forearm nerves during radial harvesting: electrophysiologic study.  J Card Surg. 2006;  21 151-154
  • 6 Siminelakis S, Karfis E, Anagnostopoulos C, Toumpoulis I, Katsaraki A, Drossos G. Harvesting radial artery and neurologic complications.  J Card Surg. 2004;  19 505-510
  • 7 Royse A G, Royse C F, Shah P. et al . Radial artery harvest technique, use and functional outcome.  Eur J Cardiothorac Surg. 1999;  15 186-193
  • 8 Galajda Z, Szentkiralyi I, Peterffy A. Neurologic complications after radial artery harvesting.  J Thorac Cardiovasc Surg. 2002;  123 194-195
  • 9 Denton T A, Trento L, Cohen M. et al . Radial artery harvesting for coronary bypass operations: neurologic complications and their potential mechanisms.  J Thorac Cardiovasc Surg. 2001;  121 951-956
  • 10 Saeed I, Annyanwu A C, Yacoub M H. et al . Subjective patient outcomes following coronary artery bypass using the radial artery: results of a cross-sectional survey of a harvest site complications and quality of life.  Eur J Cardiothorac Surg. 2001;  20 1142-1146
  • 11 Ikızler M, Ozkan S, Dernek S, Ozdemir C. et al . Does radial artery harvesting for coronary revascularization cause neurologic injury in the forearm and hand?.  Eur J Cardiothorac Surg. 2005;  28 420-424
  • 12 Grossebner M, Arifi A, Bourov Y, Taylor G, Gray S, Ritchie A. No change in O2 saturation but measurable difference in thenar flexor power after radial artery harvest.  Eur J Cardiothorac Surg. 1999;  16 160-162
  • 13 Ruengsakulrach P, Eizenberg N, Faher C. et al . Surgical implication of variations in hand collateral circulation: anatomy revisted.  J Thorac Cardiovasc Surg. 2001;  122 682-686
  • 14 Sugimoto H, Miyaji N, Ohsawa T. Carpal tunnel syndrome: evaluation of median nerve circulation with dynamic contrast-enhanced MR imaging.  Radiology. 1994;  190 459-466
  • 15 Knobloch K, Lichtenberg A, Tomaszek S. et al . Long-term physical activity and neurologic function after harvesting of the radial artery as T-graft or free graft in coronary revascularization.  Ann Thorac Surg. 2005;  80 918-921
  • 16 Galajda Z, Jagamos E, Maros T, Peterffy A. Radial artery grafts: surgical anatomy and harvesting techniques.  Cardiovasc Surg. 2002;  10 476-480
  • 17 Galajda Z, Peterffy A. Minimally invasive harvesting of the radial artery as a coronary artery bypass graft.  Ann Thorac Surg. 2001;  72 291-293
  • 18 Connoly M W, Torrillo L D, Stauder M J. et al . Endoscopic radial artery harvesting: results of first 300 patients.  Ann Thorac Surg. 2002;  74 502-506

MD Özer Kandemir

Department of Cardiovascular Surgery
Zonguldak Karaelmas University, Medical Faculty

Kozlu

06450 Zonguldak

Turkey

Phone: + 90 37 22 61 01 69

Fax: + 90 37 22 61 01 55

Email: ozerkandemir@isnet.net.tr

    >