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Ann Thorac Surg 2002;73:1359
© 2002 The Society of Thoracic Surgeons

Correspondence

Harvesting of the radial artery: skeletonization versus pedicled technique

Federico Bizzarri, MDa, Giacomo Frati, MDa

a Cardiac Surgery Unit, Università degli Studi di Siena, Viale Bracci, 53100 Siena, Italy

e-mail: bizzarri{at}unisi.it

To the Editor

We read with interest the article by Taggart and colleagues [1]. In our opinion, skeletonization of the radial artery is a dangerous technique. The rationale may be justified—to obtain extra length—but, in our experience, the pedicled artery even in a small patient can reach the main vessels on the obtuse side of the heart (most frequently) or the posterior descending artery on the right side. We skeletonize both mammaries when we use them, but the rationale is quite different: to preserve vascularization of the sternum.

The disadvantages are many: The "no touch technique" is the best method to avoid spasm and the pedicle is protective to avoid injury to the artery. Even during retrieval of the artery, there is a risk of damage to the vessel.

I do not believe the radial artery should be managed as a vein, and I think that the pharmacology is important to control to resolve the perioperative spasm. These concerns are not more important than a meticulous and sharp dissection of the vessel with all of the venae comitantes, perivascular fat, and areolar tissue.

References

  1. Taggart D.P., Mathur M.N., Ahmad I. Skeletonization of the radial artery: advantages over the pedicled technique. Ann Thorac Surg 2001;72:298-299.[Abstract/Free Full Text]

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Reply
David Taggart
Ann. Thorac. Surg. 2002 73: 1359-1360. [Extract] [Full Text] [PDF]




This Article
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