Radial artery harvesting in coronary artery bypass grafting surgery-Endoscopic or open method? A meta-analysis

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Surgical Outcomes Research

Background:

• Coronary artery bypass grafting (CABG) frequently utilizes the radial artery as a graft.
• Traditional open radial artery harvesting (OAH) carries risks of wound complications and neurological issues.
• Endoscopic radial artery harvesting (EAH) emerged as a less invasive alternative.

Purpose of the Study:

• To compare the clinical outcomes of EAH versus OAH in patients undergoing CABG.
• To evaluate differences in wound complications, neurological deficits, mortality, survival, and graft patency.

Main Methods:

• A meta-analysis of published studies comparing EAH and OAH in CABG.
• Included randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs).
• Searched databases including Pubmed, Medline, Cochrane Library, and EMBASE.

Main Results:

• EAH was associated with significantly lower rates of wound infection (RR=0.29) and neurological complications (RR=0.41).
• No significant differences were observed in 30-day mortality, long-term survival (>1 year), or graft patency rates between EAH and OAH.
• The meta-analysis included 18 studies with 2919 patients.

Conclusions:

• Endoscopic radial artery harvesting improves local wound outcomes compared to open harvesting.
• EAH is a safe alternative to OAH, with comparable long-term results regarding survival and graft function.
• Minimally invasive harvesting techniques like EAH are beneficial for CABG procedures.