75. Endoscopic radial artery harvest reduces forearm complications when compared to conventional methods: A pooled Analysis

Abstract

Impetus on total arterial revascularization has led to increased use of the radial artery as a conduit for coronary artery bypass grafting. The radial artery conduit is being increasingly as alternative to saphenous vein as conduit. Recent interest has focused on endoscopic harvest using a single small incision in the wrist. However, data comparing this with the earlier open surgical technique is limited. Methods: We have performed aggregate level meta-analysis pooling 1340 patients from six studies. The Peto odds ratio (OR) was obtained using fixed effect modeling. Continuous data was pooled as weighted mean difference (WMD). Results: Conduit length was comparable between methods [WMD 0.6(0.2–1.7) mm; p = 0.3]. Endoscopic radial artery harvest led to lower rates of wound hematoma formation [OR 0.2 (0.08–0.47); p ≤ 0.01] and wound infection [OR 0.4(0.1–0.9); p = 0.04]. However, the incidence of forearm wound exploration was comparable [OR 0.6(0.2–1.7); p = 0.34]. Conclusions: Endoscopic radial artery harvest may reduce forearm complications after radial artery harvest. It may be the procedure of choice for harvesting the radial artery when needed.