Endoscopic versus open radial artery harvesting: A meta-analysis of randomized controlled and propensity matched studies

Abstract

Background: We sought to investigate the impact of radial artery harvesting techniques on clinical outcomes using a meta-analytic approach limited to randomized controlled trials and propensity-matched studies for clinical outcomes, in which graft patency was analyzed.

Methods: A systematic literature review was conducted using PubMed and MEDLINE to identify publications containing comparisons between endoscopic radial artery harvesting (ERAH) and open harvesting (ORAH). Only randomized controlled trials and propensity-matched series were included. Data were extracted and analyzed with RevMan. The primary endpoint was wound complication rate, while secondary endpoints were patency rate, early mortality, and long-term cardiac mortality.

Results: Six studies comprising 743 patients were included in the meta-analysis. Of them 324 (43.6%) underwent ERAH and 419 (56.4%) ORAH. ERAH was associated with a lower incidence of wound complications (odds ratio: 0.33, confidence interval 0.14-0.77; p = 0.01). There were no differences in graft patency, and early and long-term cardiac mortality between the two techniques.

Conclusion: ERAH reduces wound complications and does not affect graft patency, or short- and long-term mortality compared to ORAH.

Keywords: coronary artery surgery; endoscopic radial artery harvesting; meta-analysis; patency rate; radial artery harvesting; wound complication.