Long-Term Palmar Microcirculation After Radial Artery Harvesting: An Observational Study

Background The aim of this study was to assess palmar microcirculation in a long-term follow-up after radial artery harvesting for coronary revascularization. Methods One hundred fourteen patients (100 male; aged 61.7 ± 6.7 years; preoperative New York Heart Association 2.3 ± 0.6, ejection fraction 61.4% ± 13.9%) were included after undergoing elective coronary revascularization using the radial artery of the nondominant forearm with a nonpathologic Allen’s test. Superficial and deep tissue oxygen saturation (SO2), postcapillary venous filling pressure (rHb), capillary blood flow, and capillary blood flow velocity were determined at a mean 25 ± 5 months after surgery using a combined laser Doppler spectrophotometry system. Results At 2-mm tissue depth, there was a small, but significant, decrease of 3% of superficial SO2 at the thumb and the thenar eminence (D1: 75.3% ± 8.9% versus 77.6% ± 9.7%, p = 0.003; thenar: 71.5% ± 10.5% versus 73.2% ± 8.2%, p = 0.027). Deep palmar SO2 was changed significantly at 5 of 7 positions by 3%. Deep postcapillary venous filling pressure (8 mm) was significantly increased by 9% only at the fingertip of the fifth finger (112.4 ± 49.7 versus 103.0 ± 25.0, p = 0.033), while superficial capillary blood flow decreased by 13% at only 1 of 7 positions at the hypothenar eminence (242.0 ± 153.6 versus 275.6 ± 169.2, p = 0.009). Overall, only 2 of 56 positions exceeded a given threshold of 5% change of microcirculation. No clinical signs of malperfusion were found (postoperative New York Heart Association 1.1 ± 0.4, p< 0.05), and no patient was impaired in daily palmar motor activity. Conclusions Long-term objective evaluation of superficial and deep palmar microcirculation confirms that radial artery harvesting for coronary revascularization does not compromise palmar microcirculation.