Peripheral Vascular Surgery Society

#21 UPPER EXTREMITY HEMODYNAMIC CHANGES AFTER RADIAL ARTERY HARVEST FOR CORONARY ARTERY BYPASS GRAFTING.

Joann M. Lohr, MD, Douglas S. Paget, MD, J. Michael Smith, MD, Jennifer L. Winkler, BS, RVT, and Alan R. Wladis, MD

Good Samaritan Hospital, Cincinnati, OH

Twenty-seven patients were studied with arterial duplex, PPGs, segmental pressures and pulse volume recordings both preoperatively and following radial artery harvesting. The average number of days to the follow-up visit was 66. Preoperative and postoperative data were compared using the matched Student t-test. There were no significant changes between preoperative and follow-up pressures in the brachial, radial, and ulnar arteries, and thumb, index, long, ring or little fingers. Pressure changes in the thumb and index approached but did not achieve a statistical difference. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) in the distal ulnar artery changed significantly.

	Preoperative	Follow-up	P value
PSV (m/s)	0.50 ± 0.05	0.67 ± 0.04	0.02
EDV (m/s)	0.03 ± 0.03	-0.10 ± 0.05	0.05
RI	0.97 ± 0.05	1.13 ± 0.05	0.02

Palmar arch evaluations revealed significant changes at rest and with ulnar compression (UC):

	Preoperative	Follow-up	P value
At rest - EDV (m/s)	0.03 ± 0.02	-0.05 ± 0.02	0.003
At rest - RI	0.96 ± 0.05	1.12 ± 0.05	0.01
UC - PSV (m/s)	0.23 ± 0.05	0.005 ± 0.01	0.0002
UC - RI	0.82 ± 0.11	0.27 ± 0.12	0.008

Eight patients had a variety of complaints at the follow-up visit, the majority being numbness and tingling. No patients reported symptoms of claudication or rest pain at the follow-up visit.

These data suggest that while statistically significant changes in velocity and arterial resistance do occur, patients seem to tolerate this procedure without clinical consequences.

Return to Program

Last Updated 5/28/99