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

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.