Radial Artery Harvesting
Medically reviewed by Drugs.com. Last updated on Jul 7, 2024.
AMBULATORY CARE:
What you need to know about radial artery harvesting:
Radial artery harvesting is surgery to remove a healthy part of your radial artery to create a graft. The radial artery is a large blood vessel in your forearm near your thumb. A graft is healthy tissue taken from another part of your body used to replace damaged or diseased tissue. Radial artery harvesting is done during coronary artery bypass (CABG) surgery.
How to prepare for radial artery harvesting:
- Your surgeon will tell you how to prepare. Your surgeon may tell you not to eat or drink anything after midnight on the day of your surgery. Arrange to have someone drive you home when you are discharged.
- Tell your surgeon about all medicines you currently take. Your surgeon will tell you if you need to stop any medicine for the surgery, and when to stop. Your surgeon will tell you which medicines to take or not take on the day of surgery.
- Tell your surgeon about any allergies you have, including to anesthesia or medicines. You may be given medicines to relax your blood vessels and prevent artery spasms.
- Your surgeon will tell you if you need any tests before your surgery, and when to have them.
- Your surgeon may use an ultrasound or a modified Allen test (MAT) to check the blood flow in your radial artery. An ultrasound uses sound waves to show your artery and how well blood moves through it. During a MAT, you will be asked to make a fist while your surgeon presses on your ulnar and radial arteries. The ulnar artery is in your forearm near your pinky. Your hand will become pale. You will be asked to relax your hand as pressure is taken off the ulnar artery. Your surgeon will monitor how long it takes your hand to return to its normal color.
What will happen during radial artery harvesting:
- You will be given general anesthesia to keep you asleep and free from pain during surgery. Your surgeon will make 1 or more incisions in your forearm. Your surgeon may insert an endoscope (long tube with a camera on the end) into the incision. Your surgeon may instead make 1 or more larger incisions to open your forearm.
- Your surgeon will move tissue, other blood vessels, or muscles out of the way to see the artery. Your surgeon will clamp or tie off the section of the artery that will be removed. Your surgeon will remove part of your radial artery. Medicines may be put into the removed artery to prevent blood clots or spasms.
- Your surgeon will tie off the ends of the remaining radial artery with sutures. Your surgeon will then remove the endoscope if it was used. Your surgeon may place a drain on your forearm to prevent a hematoma (collection of blood). The incisions on your forearm will be closed with stitches and may be covered with a bandage.
- Your surgeon will then perform CABG surgery. Your surgeon will sew the graft to your artery above and below the block. This allows blood to flow around the blocked area to your heart.
What to expect after radial artery harvesting:
- Healthcare providers will monitor you for any problems. When healthcare providers see you are okay you will be taken to your hospital room. You will need to stay in the hospital for several days.
- Healthcare providers will monitor your harvest site for signs of infection or bleeding. Providers may check your hand function and look for signs of decreased blood flow. Tell providers right away if your fingers feel cold or numb, or if you have trouble moving your fingers. If your surgeon placed a drain in your arm, it may be removed 24 hours after surgery.
- You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your healthcare provider says you can. Talk to healthcare providers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Press the call light button to let healthcare providers know you need help.
Risks of radial artery harvesting:
You may bleed more than expected or develop a hematoma. You may develop an infection at the harvest site. Blood vessels, muscles, or nerves in your forearm may be damaged. You may have severe loss of blood flow to your hand. This can cause loss of function, necrosis (tissue death) of your hand, or loss of the limb.
Seek care immediately if:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- Your fingers or hand become pale, cold, or numb.
- You have trouble moving your fingers.
- You have new or worsening bruising at the harvest site.
- Your harvest site is red, warm to the touch, or draining fluid.
Call your doctor or surgeon if:
- You have a fever.
- You have questions or concerns about your condition or care.
Medicines:
You may need any of the following:
- Heart medicine helps strengthen or control your heartbeat.
- Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. Many types of blood thinners are available. Your healthcare provider will give you specific instructions for the type you are given. The following are general safety guidelines to follow while you are taking a blood thinner:
- Watch for bleeding and bruising. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
- Do not start or stop any other medicines or supplements unless your healthcare provider tells you to. Many medicines and supplements cannot be used with blood thinners.
- Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
Care for the harvest site as directed:
Do not get the area wet until your healthcare provider says it is okay. When it is okay to bathe, do not scrub the area. Just let water run over it. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. Do not put powders or lotions over your harvest site. Check the area every day for signs of infection, such as redness or swelling.
Activity:
Your healthcare provider will give you specific activity instructions. The following are general guidelines to follow for up to 2 weeks after surgery:
- Do not lift anything heavier than 5 pounds until your healthcare provider says it is okay.
- Do not push or pull anything with the arm that was operated on. Examples include a car door or a vacuum cleaner.
- Do not drive until your healthcare provider says it is okay.
Prevent another blocked artery:
- Eat heart-healthy foods. You may need to eat foods that are low in salt, fat, or cholesterol. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask your healthcare provider for more information about a heart-healthy diet.
- Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause heart and lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your provider before you use these products.
- Limit or do not drink alcohol. Ask your provider if it is okay for you to drink alcohol and how much is okay to drink. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
- Maintain a healthy weight. Ask your healthcare provider what a healthy weight is for you. Obesity or overweight can increase the stress on your heart. Your provider can help you create a safe weight loss plan, if needed.
- Get vaccines as directed. Vaccines help prevent diseases that can be dangerous for a person who has heart disease. Get a flu vaccine as soon as recommended each year, usually in September or October. Get all recommended COVID-19 vaccine doses and boosters. A pneumonia vaccine may also be recommended. Your provider will tell you if you need other vaccines, and when to get them.
Follow up with your doctor or surgeon as directed:
Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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