title: Endoscopic versus open radial artery harvesting for coronary artery bypass grafting.
abstract: OBJECTIVE
  The radial artery has become the artery of choice after both internal thoracic arteries for coronary artery bypass grafting (CABG). This study compares wound healing and arm complications after endoscopic versus open radial artery harvesting.
  
  
  METHODS
  From January 2002 to July 2004, 509 patients underwent CABG including a radial artery conduit. Thirty-nine had endoscopic and 470 conventional open radial artery harvesting. A propensity score was used to obtain 1:3 matching of all endoscopic to 117 open-harvesting patients. Postoperative wound healing, local neurologic deficits, wound infection, and pain scores were compared.
  
  
  RESULTS
  Wound healing: 34 of 39 endoscopic wounds exhibited a perfect Hollander score versus 339 of 470 open-harvest wounds (p = 0.01). Wound appearance was better for endoscopic harvesting (p = 0.004). Three incomplete neurologic deficits were observed after open harvesting versus one complete neurologic deficit after endoscopic harvesting that recovered prior to hospital discharge. Incidence of wound infection was similar in both groups (p = 0.7), although infection was more severe with open harvesting. Pain score was lower (p = 0.006) with endoscopic harvesting.
  
  
  CONCLUSIONS
  Endoscopic radial artery harvesting was associated with better wound appearance and less pain. Occurrence of neurologic deficits and wound infection was infrequent in both groups.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA. naviaj@ccf.org
authors.forename: Jose L
authors.initials: JL
authors.lastname: Navia
authors.forename: Nicolas
authors.initials: N
authors.lastname: Brozzi
authors.forename: Jorge
authors.initials: J
authors.lastname: Chiu
authors.forename: Eugene H
authors.initials: EH
authors.lastname: Blackstone
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Hanson
authors.forename: Sharif
authors.initials: S
authors.lastname: Al-Ruzzeh
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Lytle
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D059348:Peripheral Nerve Injuries / Q000209:etiology; D057216:Propensity Score; D017534:Radial Artery / Q000637:transplantation*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing