Skull Base 2005; 15(3): 241-251
DOI: 10.1055/s-2005-872599
Published by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Graft Harvesting for Revascularization in the Head and Neck

Terence E. Johnson1 , John E. Wanebo2 , Stephen W. Bayles3 , Charles Y. Liu4
  • 1Department of Otolaryngology, Division of Neurosurgery, Naval Medical Center San Diego, San Diego, California
  • 2Department of Neurosciences, Division of Neurosurgery, Naval Medical Center San Diego, San Diego, California
  • 3Department of Otolaryngology, Virginia Mason Seattle Main Clinic, Seattle, Washington
  • 4Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
Further Information

Publication History

Publication Date:
17 August 2005 (online)

ABSTRACT

The techniques for revascularization in the neurocranium, skull base, and neck continue to evolve at an exciting pace. In this body of literature, however, techniques for harvesting radial artery and saphenous vein grafts are mainly reported using traditional open techniques. Minimally invasive procedures are fast becoming an alternative to open techniques in many fields and have the potential to become the standard of care. The cardiovascular literature is replete with reports of endoscopically harvested vascular grafts. This article reviews both methods, since the current state of the art involves knowledge of open and endoscopic harvesting techniques.

REFERENCES

  • 1 Sekhar L, Kalavakonda C. Cerebral revascularization for aneurysms and tumors.  Neurosurgery. 2002;  50 321-331
  • 2 Eliason J, Netterville J, Guzman R, Passman M, Naslund T. Skull base resection with cervical-to-petrous carotid artery bypass to facilitate repair of distal internal carotid artery lesions.  Cardiovasc Surg. 2002;  10 31-37
  • 3 Reilly M, Perry M, Netterville J, Meacham P. Carotid artery replacement in conjunction with resection of squamous cell carcinoma of the neck: preliminary results.  J Vasc Surg. 1992;  15 324-329
  • 4 Conley J. Free autogenous vein graft to the internal and common carotid arteries in the treatment of tumors of the neck.  Ann Surg. 1953;  137 205-214
  • 5 Lougheed W, Marshall B, Hunter M, Michel E R, Sandwith-Smyth H. Common carotid to internal carotid bypass venous graft. Technical note.  J Neurosurg. 1971;  34 114-118
  • 6 Fisch U P, Olding D J, Senning A. Surgical therapy of internal carotid artery lesions of the skull base and temporal bone.  Otolaryngol Head Neck Surg. 1980;  88 548-554
  • 7 Glassock M, Smith P, Bond A, Whitaker S, Bartels L. Management of aneurysms of the petrous portion of the internal carotid artery by resection and primary anastomosis.  Laryngoscope. 1983;  93 1445-1453
  • 8 Spetzler R, Fukushima T, Martin N, Zabramski J M. Petrous carotid-to-intradural carotid saphenous vein graft for intracavernous giant aneurysm, tumor and occlusive cerebrovascular disease.  J Neurosurg. 1990;  73 496-501
  • 9 Wolfe S Q, Tummala R P, Morcos J J. Cerebral revascularization in skull base tumors.  Skull Base. 2005;  15 71-82
  • 10 Levy M, Wang M, Aryan H, Yoo K, Meltzer H. Microsurgical keyhole approach for middle fossa arachnoid cyst fenestration.  Neurosurgery. 2003;  53 1138-1145
  • 11 Desai N, Cohen E, Naylor C, Fremes S. A randomized comparison of radial-artery and saphenous-vein coronary bypass grafts.  N Engl J Med. 2004;  351 2302-2309
  • 12 http://www.osfhealth.com/rhi/Art_Endoscopic.htm Accessed May 25, 2005
  • 13 Kubo S, Takimoto H, Yoshimine T. Endoscopically assisted harvesting of the superficial temporal artery: technical note.  Neurosurgery. 2003;  52 982-984 discussion 984-985
  • 14 Adcock O, Adcock G, Wheeler J, Gregory R, Snyder S, Gayle R. Optimal techniques for harvesting and preparation of reversed autogenous vein grafts for use as arterial substitutes: a review.  Surgery. 1984;  96 886-894
  • 15 Fremes S, Christakis G, Del Rizzo D, Musiani A, Mallidi H, Goldman B. The technique of radial artery bypass grafting and early clinical results.  J Card Surg. 1995;  10 537-544
  • 16 Possati G, Gaudino M, Prati F et al.. Long-term results of the radial artery used for myocardial revascularization.  Circulation. 2003;  108 1350-1354
  • 17 Meharwal Z, Trehan N. Functional status of the hand after radial artery harvesting: results in 3,977 cases.  Ann Thorac Surg. 2001;  72 1557-1561
  • 18 Khot U, Friedman D, Pettersson G, Smedira N, Li J, Ellis S. Radial artery bypass grafts have an increased occurrence of angiographically severe stenosis and occlusion compared with left internal mammary arteries and saphenous vein grafts.  Circulation. 2004;  109 2086-2091
  • 19 Possati G, Gaudino M, Prati F et al.. Long-term results of the radial artery used for myocardial revascularization.  Circulation. 2003;  108 1350-1354
  • 20 Lytle B. Prolonging patency-choosing coronary bypass grafts.  N Engl J Med. 2004;  351 2262-2264
  • 21 Cameron J, Trivedi S, Stafford G, Bett J. Five-year angiographic patency of radial artery bypass grafts.  Circulation. 2004;  110 (suppl 1) II-23-II-26
  • 22 Heller F, Wei W, Wei F. Chronic arterial insufficiency of the hand with fingertip necrosis 1 year after harvesting a radial forearm free flap.  Plast Reconstr Surg. 2004;  114 728-731
  • 23 Iida Y, Numata T, Shiba K, Nagata H, Terada N, Konno A. Hemodynamic changes of the hand after radial forearm flap harvesting.  Ann Plast Surg. 2002;  49 156-160
  • 24 Haerle M, Hafner H, Dietz K, Schaller H, Brunelli F. Vascular dominance in the forearm.  Plast Reconstr Surg. 2003;  111 1891-1898
  • 25 Majumdar T, Kaleekal T, Mulpuri R, Gonzalez J. Multiple saphenous vein graft aneurysms: a late complication of coronary artery bypass surgery.  Chest. 2004;  126 934S-935S
  • 26 Nwasokwa O. Coronary artery bypass graft disease.  Ann Intern Med. 1995;  123 528-545
  • 27 Sen C, Sekhar L. Direct vein graft reconstruction of the cavernous, petrous, and upper cervical internal carotid artery: lessons learned from 30 cases.  Neurosurgery. 1992;  30 732-742 discussion 742-743
  • 28 Parolari A, Rubini P, Alamanni F et al.. The radial artery: which place in coronary operation?.  Ann Thorac Surg. 2000;  69 1288-1294
  • 29 Winterer J, Ennker J, Scheffler K et al.. Gadolinium-enhanced elliptically reordered three-dimensional MR angiography in the assessment of hand vascularization before radial artery harvest for coronary artery bypass grafting: first experience.  Invest Radiol. 2001;  36 501-508
  • 30 Meharwal Z, Trehan N. Functional status of the hand after radial artery harvesting: results in 3,977 cases.  Ann Thorac Surg. 2001;  72 1557-1561
  • 31 Ghahreman K. Microvascular surgery. In: Rand RW Microneurosurgery. St. Louis, MO; CV Mosby Co 1978: 354-362
  • 32 Vasilakis V, Dashwood M, Souza D, Loesch A. Human saphenous vein and coronary bypass surgery: scanning electron microscopy of conventional and “no-touch” vein grafts.  Vascular Disease Prevention. 2004;  1 133-139
  • 33 Fabricius A, Diegeler A, Gerber W, Mohr F. Functional and morphologic assessment of saphenous veins harvested with minimally invasive techniques using a modified laryngoscope. 2000 #2000-04157. Available at: http://www.hsforum.com/stories/articleReader$231. Accessed May 25, 2005
  • 34 Swinamer S, Fox S, McKenzie F et al.. Endoscopic saphenous vein harvesting for CABG can be performed utilizing a reusable system with greatly reduced cost as compared to disposable systems [abstract]. 2004 Canadian Cardiovascular Congress. Available at: http://www.pulsus.com/ccc2004/abs/a411.htm. Accessed May 25, 2005
  • 35 Ali I, El-Khateeb O. Less invasive non-endoscopic saphenous vein harvesting: a simple technique and super results [abstract]. 2001 Canadian Cardiovascular Congress. Available at: http://www.ccs.ca/society/congress2001/abstracts/abs/a034.htm. Accessed May 25, 2005
  • 36 Taggart D. The radial artery as a conduit for coronary artery bypass grafting.  Heart. 1999;  82 409-410
  • 37 Wright C B, Barner H B, Gao A et al.. The advantages of the Harmonic Scalpel for the harvesting of radial arteries for coronary artery bypass.  Heart Surg Forum. 2001;  4 226-229 discussion 229-230
  • 38 Cable D, Caccitolo J, Caplice N et al.. The role of gene therapy for intimal hyperplasia of bypass grafts.  Circulation. 1999;  100 II-392-II-396
  • 39 Davis Z, Garber D, Clark S et al.. Long-term patency of coronary grafts with endoscopically harvested saphenous veins determined by contrast-enhanced electron beam computed tomography.  J Thorac Cardiovasc Surg. 2004;  127 823-828
  • 40 Connolly M, Torrillo L D, Stauder M J et al.. Endoscopic artery harvesting: results of first 300 patients.  Ann Thorac Surg. 2002;  74 502-505 discussion 505-506
  • 41 Liu C, Spicer M, Apuzzo M. The genesis of neurosurgery and the evolution of the neurosurgical operative environment: part II-concepts for future development, 2003 and beyond.  Neurosurgery. 2003;  52 20-35

Terence E JohnsonM.D. 

Department of Otolaryngology, Naval Medical Center San Diego

34520 Bob Wilson Dr., Ste. 200

San Diego, CA 92134-2200

Email: tejohnson@nmcsd.med.navy.mil