Pain from radial artery harvesting resolves within first year

Harvesting the radial artery for CABG may be more painful for patients in the early post-operative period than harvesting the saphenous vein, researchers found in a study published online Sept. 25 in JAMA Surgery. But the pain resolved within 12 months of surgery.

The researchers, led by William L. Holman, MD, of the Alabama VA Medical Center in Birmingham, used data from patients enrolled in the Department of Veterans Affairs’ Cooperative Studies Program (CSP) 474. CSP 474 was a multicenter, randomized, prospective study that assessed angiographic graft patency one year after elective CABG.

“The purpose is to quantitatively define the severity of pain and motor impairment associated with procurement of the radial artery and then compare pain and motor impairment with the unoperated-on arm,” the authors wrote.

CSP 474 included more than 6,000 patients at 11 hospitals, and 751 were included in Holman et al’s study. They analyzed pain at the harvest site using a pain scale of 0 to 100 (with 100 being the most painful) and hand sensory function. They measured grip strength using weights on a dynamometer and hand dexterity by timing the 9-hole peg test.

Patients who had a radial artery harvesting experienced significantly more pain three months after their CABG than the patients who had saphenous vein harvest, although the pain was not severe. However, the pain resolved one year after the procedure. Radial artery harvesting did not lead to a significant change in grip strength or manual dexterity during either post-operative period.

“The 9-hole peg test and grip strength cannot discern changes in sensory or motor function for especially demanding situations (eg, the hands of a pianist) but are nevertheless reassuring regarding the outcome for most patients who undergo this procedure,” the authors wrote.