title: Endoscopic versus open radial artery harvesting for coronary artery bypass grafting.
abstract: OBJECTIVE
  The radial artery has become the artery of choice after the internal thoracic artery for coronary artery bypass grafting (CABG). This study compares wound healing and arm complications after endoscopic versus open radial artery harvesting for CABG.
  
  
  METHODS
  From January 2002 to July 2004, 509 patients underwent CABG in which a radial artery conduit was used. Thirty-nine had endoscopic and 470 had 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 using the Hollander scale, 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 in particular was better than for open harvesting (P=0.004), with no abnormal step-off borders, irregular contours, or abnormal scar width observed. Neurologic deficits. Three incomplete neurologic deficits were observed after open harvesting (two being distal sensitivity localized in the interspace between the first and second metacarpals); one complete neurologic deficit occurred after endoscopic harvesting, but improved remarkably prior to hospital discharge. Wound infection. Occurrence of wound infection was similar in the two groups (P=0.7), although infection was more severe with open harvesting. Pain: pain score was lower (P=0.006) with endoscopic harvesting.
  
  
  CONCLUSIONS
  Compared with conventional open harvesting, 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, OH 44195, USA. naviaj@ccf.org
authors.forename: J L
authors.initials: JL
authors.lastname: Navia
authors.forename: N
authors.initials: N
authors.lastname: Brozzi
authors.forename: J
authors.initials: J
authors.lastname: Chiu
authors.forename: E H
authors.initials: EH
authors.lastname: Blackstone
authors.forename: F A
authors.initials: FA
authors.lastname: Atik
authors.forename: L G
authors.initials: LG
authors.lastname: Svensson
authors.forename: A M
authors.initials: AM
authors.lastname: Gillinov
authors.forename: G L
authors.initials: GL
authors.lastname: Hanson
authors.forename: S
authors.initials: S
authors.lastname: Al-Ruzzeh
authors.forename: J
authors.initials: J
authors.lastname: Feng
authors.forename: B W
authors.initials: BW
authors.lastname: Lytle
mesh_terms: D001026:Coronary Artery Bypass / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D017534:Radial Artery / Q000637:transplantation*; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome