Endoscopic Harvesting Linked to Adverse Outcomes

Compared to open harvesting, it's associated with higher rates of vein-graft failure and death

WEDNESDAY, July 15 (HealthDay News) -- In patients who undergo coronary-artery bypass grafting, endoscopic harvesting is associated with significantly poorer clinical outcomes, including mortality, than open harvesting, according to a study published in the July 16 issue of the New England Journal of Medicine.

Renato D. Lopes, M.D., of Duke University Medical Center in Durham, N.C., and colleagues studied 1,753 patients who underwent endoscopic harvesting and 1,247 patients who underwent open harvesting.

After 12 to 18 months, the researchers found that patients who underwent endoscopic harvesting had a higher risk of vein-graft failure (46.7 versus 38 percent). After three years, they also found that patients who underwent endoscopic harvesting had higher rates of death, myocardial infarction, or repeat revascularization (20.2 versus 17.4 percent), death or myocardial infarction (9.3 versus 7.6 percent), and death (7.4 versus 5.8 percent).

"The mechanism behind these findings requires further investigation, and randomized clinical trials evaluating the effect of endoscopic harvesting on long-term angiographic and clinical outcomes are needed," the authors conclude. "Until further data are available, the increased risk of worse outcomes with endoscopic harvesting should be weighed against its known short-term benefits."

The PREVENT IV trial, on which this study was based, was funded by a grant from Corgentech (now Anesiva). A co-author reported a financial relationship with MAQUET.

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