Endoscopic versus Open radial artery harvesting for Coronary Bypass Grafting; one-year patency rates

Anhar  Abdellatif; Mohamed  Alassal; Mohamed Meselhy

Anhar Abdellatif Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Benha, Egypt
Mohamed Alassal Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Benha, Egypt
Mohamed Meselhy Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Keywords: Endoscopic, Radial Artery, Coronary Bypass Grafting, Open Harvesting, Radial artery harvesting

Abstract

Background: Research is ongoing on the effects of endoscopic radial artery harvesting (ERAH) on clinical outcomes and patient satisfaction. This study evaluated the clinical outcomes, patient satisfaction, and radial artery graft patency of ERAH compared with the open technique (ORAH) for coronary artery bypass grafting (CABG).

Methods: We conducted a randomized controlled clinical trial involving 100 patients who underwent on-pump elective CABG with three or four vessels. Patients were randomly allocated into two groups: the ERAH group consisted of 50 individuals who underwent radial artery harvesting via endoscopy, whereas the ORAH group included 50 patients whose radial arteries were harvested via the conventional open technique. The study outcomes included the length of radial artery harvest, operating time, and postoperative outcomes, including hematoma formation, wound infection, and local neurological issues related to lesions of the dorsal radial nerve.

Results: Hospital stays were significantly shorter in the ERAH group than in the ORAH group (7.06 ± 0.79 days vs. 7.9 ± 0.81 days, P < 0.001). Additionally, peripheral neurological complications were significantly different between the groups, occurring in none of the patients in the ERAH group but in 6 patients (12%) in the ORAH group. Wound healing was also significantly better in the ERAH group than in the ORAH group (100% vs. 88%, P = 0.027), with all patients in the ERAH group experiencing seamless wound healing. In the ORAH group, two patients (4%) had wound infections, and four patients (8%) developed hematomas. Both groups presented similar rates of perioperative ischemia and radial artery graft patency. Patient satisfaction was significantly better in the ERAH group (P<0.001).

Conclusion: After one year, the patency rates of ERAH and ORAH were similar. However, patient satisfaction and wound healing were better in the ERAH group.