Wright C B, Barner H B, Gao A, Obial R, Bandy B, Perry L, Ronan J, Kelly C R
Jewish Hospital, Cincinnati, OH, USA.
Heart Surg Forum. 2001;4(3):226-29; discussion 229-30.
Improvements in replacement vessel harvesting techniques and antispasmodic agents since the 1970s have led to a resurgence of interest in the radial artery (RA) as a conduit for coronary revascularization.
This randomized study compared the Ultra Cision Harmonic Scalpel (HS) (Ethicon Endo-Surgery, Inc., Cincinnati, OH) and the cold steel scalpel (CSS) for harvesting radial arteries to be used in coronary artery bypass grafting (CABG) procedures. Men and non-pregnant women, aged 21 to 79 years, with myocardial ischemia or coronary stenosis who were scheduled to undergo coronary bypass were enrolled in the study.
Harvesting of the radial artery by the Harmonic Scalpel required a significantly lower number of clips to control bleeding. There was no significant difference between the times required to harvest the artery with either device. There were no complications, malfunctions, or serious adverse events associated with the use of either device.
The Harmonic Scalpel provides excellent control of bleeding compared to the cold steel scalpel, and its use permits bleeding to be controlled without the need for potentially damaging electrocautery. No clinically significant adverse events were associated with the use of the Harmonic Scalpel.
自20世纪70年代以来,替代血管获取技术和抗痉挛药物的改进使得人们对桡动脉(RA)作为冠状动脉血运重建管道的兴趣再度兴起。
本随机研究比较了用于冠状动脉旁路移植术(CABG)中获取桡动脉的超声刀(HS)(爱惜康内镜外科公司,俄亥俄州辛辛那提)和冷钢手术刀(CSS)。年龄在21至79岁、患有心肌缺血或冠状动脉狭窄且计划接受冠状动脉搭桥手术的男性和非妊娠女性被纳入研究。
使用超声刀获取桡动脉时控制出血所需的夹子数量显著更少。两种器械获取动脉所需时间无显著差异。使用这两种器械均未出现并发症、故障或严重不良事件。
与冷钢手术刀相比,超声刀能更好地控制出血,使用它无需进行可能造成损伤的电灼即可控制出血。使用超声刀未出现具有临床意义的不良事件。