Reyes A T, Frame R, Brodman R F
Department of Cardiothoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467.
Ann Thorac Surg. 1995 Jan;59(1):118-26. doi: 10.1016/0003-4975(94)00673-U.
The radial artery was proposed and then abandoned as a coronary artery bypass graft in the 1970s. Development of new pharmacologic antispasmodic agents and minimally traumatic harvesting techniques has led to a revival of the use of the radial artery in coronary artery bypass procedures. Unlike the saphenous vein in the lower extremities, the radial artery in the volar forearm is not a subcutaneous structure. Safe harvest of the artery requires an understanding of volar forearm anatomy. Based on review of anatomy, cadaver dissection, and clinical experience with 40 patients, we have developed a technique for radial artery harvest. The volar forearm is divided into three zones: the proximal zone, the middle zone, and the distal zone. In each zone, important anatomic landmarks are identified. Our harvesting technique has resulted in minimal postoperative morbidity and no postoperative ischemic complications. Although the pedicled internal thoracic artery graft remains the primary arterial conduit for myocardial revascularization, the radial artery is an excellent additional bypass conduit.
20世纪70年代，桡动脉曾被提议用于冠状动脉搭桥手术，但随后又被弃用。新型抗痉挛药物和微创获取技术的发展，使得桡动脉在冠状动脉搭桥手术中的应用得以复兴。与下肢的大隐静脉不同，掌侧前臂的桡动脉不是皮下结构。安全获取该动脉需要了解掌侧前臂的解剖结构。基于解剖学回顾、尸体解剖以及对40例患者的临床经验，我们开发了一种桡动脉获取技术。掌侧前臂分为三个区域：近端区域、中间区域和远端区域。在每个区域，确定重要的解剖标志。我们的获取技术使术后发病率降至最低，且未出现术后缺血性并发症。尽管带蒂胸廓内动脉移植物仍然是心肌血运重建的主要动脉管道，但桡动脉是一种出色的额外旁路管道。
