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

Evelio Rodriguez, Michael L. Ormont, Erica H. Lambert, Laurence Needleman, Ethan J. Halpern, James T. Diehl, Richard N. Edie, John D. Mannion

    Research output: Contribution to journalArticle

    42 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish (US)
    Pages (from-to)135-139
    Number of pages5
    JournalEuropean Journal of Cardio-thoracic Surgery
    Volume19
    Issue number2
    DOIs
    StatePublished - Jan 1 2001

    Fingerprint

    Radial Artery
    Plethysmography
    Coronary Artery Bypass
    Doppler Ultrasonography
    Hand
    Arm
    Rehabilitation
    Ischemia
    Pressure
    Perfusion
    Incidence

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Pulmonary and Respiratory Medicine
    • Cardiology and Cardiovascular Medicine

    Cite this

    Rodriguez, E., Ormont, M. L., Lambert, E. H., Needleman, L., Halpern, E. J., Diehl, J. T., ... Mannion, J. D. (2001). The role of preoperative radial artery ultrasound and digital plethysmography prior to coronary artery bypass grafting. European Journal of Cardio-thoracic Surgery, 19(2), 135-139. https://doi.org/10.1016/S1010-7940(00)00626-6

    The role of preoperative radial artery ultrasound and digital plethysmography prior to coronary artery bypass grafting. / Rodriguez, Evelio; Ormont, Michael L.; Lambert, Erica H.; Needleman, Laurence; Halpern, Ethan J.; Diehl, James T.; Edie, Richard N.; Mannion, John D.

    In: European Journal of Cardio-thoracic Surgery, Vol. 19, No. 2, 01.01.2001, p. 135-139.

    Research output: Contribution to journalArticle

    Rodriguez, E, Ormont, ML, Lambert, EH, Needleman, L, Halpern, EJ, Diehl, JT, Edie, RN & Mannion, JD 2001, 'The role of preoperative radial artery ultrasound and digital plethysmography prior to coronary artery bypass grafting', European Journal of Cardio-thoracic Surgery, vol. 19, no. 2, pp. 135-139. https://doi.org/10.1016/S1010-7940(00)00626-6
    Rodriguez, Evelio ; Ormont, Michael L. ; Lambert, Erica H. ; Needleman, Laurence ; Halpern, Ethan J. ; Diehl, James T. ; Edie, Richard N. ; Mannion, John D. / The role of preoperative radial artery ultrasound and digital plethysmography prior to coronary artery bypass grafting. In: European Journal of Cardio-thoracic Surgery. 2001 ; Vol. 19, No. 2. pp. 135-139.
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    abstract = "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.",
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    AU - Ormont, Michael L.

    AU - Lambert, Erica H.

    AU - Needleman, Laurence

    AU - Halpern, Ethan J.

    AU - Diehl, James T.

    AU - Edie, Richard N.

    AU - Mannion, John D.

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