A comparison of endovascular assisted and conventional in situ bypass grafts

Minimally Invasive Vein Harvesting: A Comparison of Endoscopic Versus Traditional Open Saphenectomy

The greater saphenous vein (SV) is the conduit of choice for coronary and infrapopliteal revascularization procedures. Unfortunately, to harvest an SV it is often necessary to make an incision the length of the leg, and this is associated with a significant incidence of wound complications. Minimally invasive procedures have several advantages including reduced incidence of wound complications, decreased hospital length of stay, and, therefore, health-care savings. Currently, little information is available that compares traditional open saphenectomy (OS) versus a minimally invasive procedure, endoscopic saphenectomy (ES). The purpose of this study was to compare SV harvest time, incision length, and harvested vein quality between the OS and ES techniques in six nonpreserved cadavers.

Each limb was randomly selected for either OS or ES. The length of incision, number of SV leaks after harvest, length of SV, and time required for harvest were recorded for each technique. (continued on next page)

The table summarizes the findings of the cadaver dissections.

Per limb, no difference was noted in vein harvest length or number of leaks between OS and ES. A significant reduction was found in incision length for ES (14.4 ±1.4 cm per limb), but the time required for OS was significantly shorter (P=0.01).

This study suggests an equivalent length of SV can be harvested with either OS or ES techniques; however, with the ES technique there is a reduction in incision length and, therefore, a less morbid operative technique.