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Ann Thorac Surg 2004;77:2238-2246
© 2004 The Society of Thoracic Surgeons

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Review

Should the internal thoracic artery be skeletonized?

^a The National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Department of Cardiothoracic Surgery, St Mary's Hospital, London, United Kingdom

^* Address reprint requests to Dr Athanasiou, Cardiothoracic Surgery, 70 St. Olaf's Rd, Fulham, London SW6 7DN, UK.
e-mail: tathan5253{at}aol.com

Traditionally, the internal thoracic artery is harvested as a pedicle. In contemporary cardiac surgical practice, however, certain surgeons practice the internal thoracic artery-skeletonization technique. A systematic review of clinical studies reporting on the use of skeletonized internal thoracic arteries (SKT-ITA) has not yet been performed. The primary aim of this review article is to examine comprehensively the entire body of evidence regarding the use of SKT-ITA. In particular, we aimed to analyze the effects of skeletonization on sternal blood supply, wall damage and blood flow in the harvested vessel, postoperative graft patency, and clinical outcome. Advantages and disadvantages of the skeletonization technique are highlighted and discussed.

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