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INFLUENCE OF ENDOSCOPIC HARVESTING ON RADIAL ARTERY GRAFT QUALITY
Mani Arsalan, Anke Gitschmann, Johannes Blumenstein, Arnaud Van Linden, Sebastian Szardien, Helge Möllmann, Thomas Walther, Jörg Kempfert.
Kerckhoff Clinic, Bad Nauheim, Germany.

OBJECTIVE: Several studies showed an improved patient satisfaction combined with less wound healing disturbances after endoscopic radial artery harvesting.
Despite these findings endoscopic harvesting is, especially outside the USA, still not standard of care. Concerns regarding graft quality after endoscopic harvesting are the main reason against the minimal invasive technique.

METHODS: In this randomized trial we investigated radial artery quality after endoscopic or conventional surgical graft harvesting in patients (n=50) undergoing coronary artery bypass grafting.
The endoscopic harvesting was performed using the Storz Endovein
retractor (Karl Storz, Tuttlingen, Germany) combined with the Starion STLS device (Starion Instruments, Sunnyvale, USA).
After harvesting, the proximal part of the radial artery was histologically examined using different endothelial markers (CD31, eNOS, VCAM and ICAM) to investigate endothelial integrity.

RESULTS: We could not detect a significant difference in graft quality between the two harvesting techniques. There were no differences regarding the rate of transmural or intimal injuries.

CONCLUSIONS: Consequently based on the 2005 ISMICS consensus statement and our findings, showing that endoscopic harvesting does not influence graft quality, radial artery harvesting should be performed endoscopically as standard of care.


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