Endoscopic radial artery harvesting reduces postoperative pain and neurologic complications.
BACKGROUND
Endoscopic radial artery harvest provides better cosmetic result without compromising the quality of the graft. We sought to compare postoperative harvesting site neurologic and vascular outcome.


METHODS
From 10/2002 until 10/2004, 50 patients were randomized to have their radial artery harvested for coronary bypass either endoscopically (group A, n = 25) or conventionally (group B, n = 25). Radial arteries were preoperatively evaluated by Doppler echocardiography. Neurologic and functional status was assessed by a self reporting questionnaire with a semiquantitative (1-5) scale. Vascular status of the forearm was assessed by control echocardiography.


RESULTS
At an average follow-up of 37 +/- 7 months, patients undergoing endoscopic radial artery harvesting had less overall neurologic complications (11 versus 17 patients, P = .023) and they were less severe (0.8 +/- 1.1 versus 2.2 +/- 1.2; P < .001). Ulnar flow increase was similar among the groups: 13.1 +/- 5.43 cm/s in group A versus 15.9 +/- 4.9 cm/s in group B (P = .147) as well as ulnar artery diameter increase 0.29 +/- 0.16 mm in group A versus 0.29 +/- 0.26 cm in group B (P = .914).


CONCLUSIONS
Endoscopic radial artery is safe and does not compromise graft quality or forearm and hand circulation postoperatively. Along with providing a better cosmetic result, endoscopic artery harvesting reduces postoperative harvesting site pain and neurologic complications.
Rudez
Igor
I
Division of Cardiac Surgery, Dubrava University Hospital, Zagreb, Croatia. rudi@kbd.hr
Unic
Daniel
D
Sutlic
Zeljko
Z
Biocina
Bojan
B
Baric
Davor
D
Ivkovic
Mira
M
Pavlovic
Mirjana
M
D001783:Blood Flow Velocity; D001026:Coronary Artery Bypass / Q000379:methods*; D015150:Echocardiography, Doppler; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000601:surgery* / Q000637:transplantation; D017535:Ulnar Artery / Q000000981:diagnostic imaging