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BACKGROUND: The radial artery (RA) propensity for vasospasm and vulnerability to surgical trauma is well known. A less invasive endoscopic method to harvest the RA was recently introduced, but its effect on RA integrity is unknown. METHODS: To compare the effects of harvest method on RA function, we prospectively randomized 54 patients undergoing coronary artery bypass grafting with the RA into 3 groups based on harvest techniques: endoscopic (Endo), conventional with cautery (ConC) and conventional with harmonic scalpel (ConH). We assessed endothelium-dependent and -independent relaxation of RA segments to sequential doses acetylcholine (Achol) and nitroglycerin (NTG), respectively, using standard organ chamber methodology. Vasospasm was assessed as the vasoconstrictor response to the thromboxane analog U46619. We assessed endothelial integrity by rating ICAM-1, VCAM-1 and P-Selectin expression by immunohistology using a semiquantitative 0 to 3 scale. Harvest procedures were performed by a single surgeon and data analyses were blinded to the harvesting method.
RESULTS: As shown in the table, maximal relaxation / contraction (E_max) responses, effective drug concentration yielding 50% response (EC₅₀), and adhesion molecule expression were similar in the three groups.