[HSF] Another Victory for the LAD Stent.....

[Michael Firstenberg]

Don,

With your experience with radials - probably the largest I have heard about
- tell us what you do.
1) Do you soak it in anything once harvested?
2) Which direction of flow (I assume normal anatomic)
3) Skeletonize?  Pedicle?
4) Anything different on the anastamosis?
5) Post-operative management?  Ca++ blockers (I have heard that they are not
needed)

How do you select?
Which ones don't you use?
  - how do you decide pre-op vs intra-op?
This may sound silly, but if you have such good results (which I am not
doubting) - does it not make sense to take it from the dominant hand?  Would
that be a more mature artery?  Do you use bilateral radials?  What do you do
about arterial monitoring - do you put O2 sat monitoring on the fingers?


-michael

On 2/10/08, Hgrmd at aol.com <Hgrmd at aol.com> wrote:
>
> Don,
> For once I agree with you.  It's a little distressing the way  the
> majority
> of us continue to rely on the saphenous vein, when arterial  conduits are
> available to those willing to work a little longer and  harder.  My PA's
> harvest
> radials endoscopically through a stab wound at the  wrist.  We've yet to
> see
> an ischemic problem, because we carefully screen  pre- and
> intraoperatively for
> inadequate ulnar or palmar arch flow.  I  asked one of my junior
> associates
> why he basically only used the LIMA and  veins.  He sheepishly admitted
> that
> the increased time and effort was a  major factor in his decision.
>
> Hal
>
>
>
> **************Biggest Grammy Award surprises of all time on AOL Music.
> (
> http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp003000000025
> 48)
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