Related Experiment Video
Updated: Aug 16, 2026
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Valvulotomy of non-reversed saphenous vein bypass grafts: a randomised, blinded, angioscopy-controlled study
A Albäck1, I Kantonen, L Ihlberg
1Division of Vascular Surgery, Department of Surgery, Helsinki, Finland.
Objectives:
to compare the result of vein valve disruption with two different valvulotomes during non-reversed saphenous vein bypass.
Design:
a randomised, blinded clinical study.
Materials And Methods:
twenty patients undergoing femorodistal non-reversed saphenous vein arterial bypass were randomised into two equal groups. Valve leaflet disruption was performed either with a standard size plastic valvulotome or with a metal valvulotome with an exchangeable cutting head. Valvulotomy was done after full exposure of the vein and completion of the proximal anastomosis. The result was evaluated by a surgeon blinded to the valvulotome used, using angioscopy.
Results:
a total of 219 valve cusps were inspected with angioscopy. There were 83 completely lysed cusps (69%) by plastic and 76 (78%) by metallic valvulotomes (p=0.14). Of all the incompletely lysed cusps 12 (29%) occurred in the most proximal valve pocket treated with valvulotomy.
Conclusions:
no significant difference in performance between the investigated valvulotomes was found. Incomplete valvulotomy occurred mainly in the proximal part of the vein and was obviously caused by a size mismatch between the diameter of vein and the valvulotome. Construction of a valvulotome with a variable diameter cutting head is therefore recommended.
