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. 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). 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]. 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.