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Skeletonization of radial and gastroepiploic conduits in coronary artery bypass surgery

Title: Skeletonization of radial and gastroepiploic conduits in coronary artery bypass surgery
Authors: Massey, RM
Warren, OJ
Szczeklik M
Wallace, S
Leff, DR
Kokotsakis J
Darzi, A
Item Type: Journal Article
Abstract: The use of a skeletonized internal thoracic artery in coronary artery bypass graft surgery has been shown to confer certain advantages over a traditional pedicled technique, particularly in certain patient groups. Recent reports indicate that radial and gastroepiploic arteries can also be harvested using a skeletonized technique. The aim of this study is to systematically review the available evidence regarding the use of skeletonized radial and gastroepiploic arteries within coronary artery bypass surgery, focusing specifically on it's effect on conduit length and flow, levels of endothelial damage, graft patency and clinical outcome. Four electronic databases were systematically searched for studies reporting the utilisation of the skeletonization technique within coronary revascularisation surgery in humans. Reference lists of all identified studies were checked for any missing publications. There appears to be some evidence that skeletonization may improve angiographic patency, when compared with pedicled vessels in the short to mid-term. We have found no suggestion of increased complication rates or increased operating time. Skeletonization may increase the length of the conduit, and the number of sequential graft sites, but no clear clinical benefits are apparent. Our study suggests that there is not enough high quality or consistent evidence to currently advocate the application of this technique to radial or gastroepiploic conduits ahead of a traditional pedicled technique.
Issue Date: 5-Jun-2007
Date of Acceptance: 5-Jun-2007
URI: http://hdl.handle.net/10044/1/44602
DOI: http://dx.doi.org/10.1186/1749-8090-2-26
ISSN: 1749-8090
Publisher: BioMed Central
Journal / Book Title: Journal of Cardiothoracic Surgery
Volume: 2
Copyright Statement: © 2007 The Authors. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
CARDIAC & CARDIOVASCULAR SYSTEMS
Blood Vessel Prosthesis
Coronary Artery Bypass
Gastroepiploic Artery
Humans
Radial Artery
Respiratory System
1103 Clinical Sciences
Article Number: 26
Appears in Collections:Department of Surgery and Cancer
Institute of Global Health Innovation