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Saphenous vein angioscopy: a valuable method to detect unsuspected venous disease
C M Sales1, M L Marin, F J Veith
1Division of Vascular Surgery, Montefiore Medical Center-Albert Einstein College of Medicine, New York, NY 10467.
Journal of Vascular Surgery
|August 1, 1993
Summary
Angioscopy can detect hidden saphenous vein disease, potentially improving bypass graft success. This method offers a reliable way to assess vein quality before arterial reconstruction surgery.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Histopathology
Background:
- Preexisting saphenous vein lesions negatively impact graft patency in arterial reconstruction.
- Standard preoperative and intraoperative evaluations may fail to detect significant vein disease.
Purpose of the Study:
- To evaluate angioscopy's effectiveness in detecting previously unrecognized saphenous vein lesions.
- To determine if angioscopy can improve the assessment of vein quality for bypass grafting.
Main Methods:
- Ninety saphenous vein remnants from bypass surgery were analyzed using both angioscopy and histology.
- Independent examiners assessed specimens based on angioscopic and microscopic findings.
- Vein segments were categorized as normal or abnormal based on visual and histological criteria.
Main Results:
- Angioscopy correctly identified sclerotic and postphlebitic vein changes.
- Histology confirmed angioscopic findings in most cases; all abnormal angioscopic findings correlated with disease.
- Angioscopy missed some vein abnormalities, including thick-walled and varicose segments, reducing its overall sensitivity.
Conclusions:
- Angioscopy identified unsuspected saphenous vein disease in several patients.
- Routine angioscopy may enhance prospective vein assessment and improve arterial reconstruction graft patency.
- This technique shows promise for improving outcomes in patients undergoing saphenous vein bypass grafting.