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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

Published on: November 19, 2019

Current status of endoscopic vein harvest in cardiac and peripheral vascular surgery

Kimberly Dao1, Rafael D Malgor, JoAnn Montecalvo

  • 1School of Medicine, SUNY, Stony Brook, NY, USA.

Cardiology in Review
|March 16, 2012
PubMed

Insights

Endoscopic vein harvest (EVH) reduces surgical complications but may impact bypass graft patency. This review examines studies comparing EVH to open vein harvest for long-term graft success.

Area of Science:

  • Vascular Surgery
  • Graft Patency Studies
  • Minimally Invasive Techniques

Background:

  • Endoscopic vein harvest (EVH) offers reduced wound morbidity compared to open vein harvest for bypass procedures.
  • Long-term success of bypass surgery relies heavily on the patency of the harvested vein conduit.
  • Conflicting evidence exists regarding the long-term patency rates of grafts harvested via EVH versus open techniques.

Purpose of the Study:

  • To review and synthesize findings on the long-term patency of saphenous vein grafts obtained through EVH compared to open vein harvest.
  • To explore potential biological and functional reasons for discrepancies in graft patency between the two harvesting methods.
  • To evaluate clinical outcomes, including wound complications and graft patency, for both EVH and open vein harvest in coronary and lower extremity bypass.

Main Methods:

  • Literature review of microscopic, electron microscopic, and functional studies on venous endothelium and vein contractile function.
  • Analysis of clinical data comparing early wound complications and short- to long-term patency rates for EVH and open vein harvest.
  • Synthesis of results from studies investigating the biological mechanisms potentially affecting graft patency.

Main Results:

  • Studies suggest potentially decreased long-term patency rates with EVH compared to open vein harvest.
  • Microscopic and functional studies have yielded conflicting results regarding endothelial and contractile function of EVH conduits.
  • Clinical outcomes regarding wound complications and patency rates require careful consideration of harvesting methods.

Conclusions:

  • While EVH offers advantages in wound healing, its impact on long-term bypass graft patency remains a critical area of investigation.
  • Further research is needed to elucidate the mechanisms behind potential patency differences and optimize EVH techniques.
  • The choice between EVH and open vein harvest should balance early wound benefits against potential long-term conduit performance.

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