Upper extremity hemodynamic changes after radial artery harvest for coronary artery bypass grafting

Twenty-seven patients were studied with arterial duplex, photoplethysmograp hy, segmental pressures, and pulse volume recordings both preoperatively an d following radial artery harvesting. The average number of days to the fol low-up visit was 66. Preoperative and postoperative data were compared usin g the matched Student's t-test. There were no significant changes between p reoperative and postoperative pressures in the brachial, radial, and ulnar arteries, and thumb, index, long, ring, or little fingers. Pressure changes in the thumb and index finger approached but did not achieve a statistical difference. Peak systolic velocity (PSV), end diastolic velocity (EDV), an d resistive index (RI) in the distal ulnar artery changed significantly bet ween preoperative and postoperative measurements. PSV changed from 0.50 +/- 0.05 m/sec to 0.67 +/- 0.04 m/sec (p = 0.02); EDV changed from 0.03 +/- 0. 03 m/sec to -0.10 +/- 0.05 m/sec (p = 0.05); and RI changed from 0.97 +/- 0 .05 to 1.13 +/- 0.05 (p = 0.02). Palmar arch evaluations revealed significa nt changes at rest and with ulnar compression between preoperative and post operative measurements: (1) at rest EDV changed from 0.03 +/- 0.02 m/sec to -0.05 +/- 0.02 m/sec (p < 0.01); (2) at rest RI changed from 0.96 +/- 0.05 to 1.12 +/- 0.05 (p = 0.01); (3) with ulnar compression the PSV changed fr om 0.23 +/- 0.05 m/sec to 0.005 +/- 0.01 m/sec (p < 0.01); and (4) with uln ar compression the RI changed from 0.82 +/- 0.11 to 0.27 +/- 0.12 (p < 0.01 ). Eight patients had a variety of complaints at the follow-up visit, the m ajority being numbness and tingling. No patients reported symptoms of claud ication or rest pain at the follow-up visit. The data suggest that while st atistically significant changes in velocity and arterial resistance do occu r, patients seem to tolerate radial artery harvesting without clinical cons equences. The ideal method of preoperative evaluation remains to be determi ned. DOI: 10.1007/s100169910010.