Radial artery harvesting for coronary bypass operations: Neurologic complications end their potential mechanisms

Objectives: We sought to determine the incidence of self-reported neurologi c hand complications after radial artery harvest for coronary artery bypass grafting, Methods: Between February 20, 1996, and December 31, 1999, 615 patients und erwent coronary bypass operations with radial arteries. A scripted telephon e interview was performed, collecting data on perceived thumb weakness and sensation abnormalities in the distribution of the radial nerve in 560 pati ents. The average time to follow-up interview was 14.5 +/- 9 months. Results: Neurologic complications were reported in 30.1%, decreased thumb s trength in 5.5%, and any sensation abnormality in 18.1% of patients. There was a high rate of symptom improvement over an average of 8.7 +/- 7.5 month s, such that only 12.1% of patients reported symptoms without any improveme nt. Associations between thumb weakness and sensory abnormalities imply med ian nerve damage in some patients. There were statistically significant ass ociations between neurologic complications and diabetes, peripheral vascula r disease, elevated creatinine levels, smoking, and number and site of radi al artery harvest. Conclusions: The overall rate of self-reported neurologic complications aft er radial artery harvest was higher than previously reported. These symptom s may be attributable to radial and median nerve injury caused by trauma an d devascularization. These data have important implications not only in att empting to improve harvesting techniques but also in guiding informed conse nt before coronary artery bypass grafting.