Endoscopic saphenous vein and radial harvest

Abstract

Endoscopic conduit harvesting can be performed safely and effectively with the currently available techniques, albeit a careful knowledge of the pitfalls of each technique is mandatory. Since there is ample evidence in literature that a minimally invasive approach for saphenous vein and radial artery procurement is not associated with an increased risk of graft damage and related failure in the mid-long term, the endoscopic technique should be adopted as the approach of choice for saphenous vein and radial artery harvesting in coronary artery bypass graft surgery.

Open radial artery harvesting better preserves endothelial function compared to the endoscopic approach

“…In a small randomized trial, Burns et al [21] reported similar mid-term patency rate for RA grafts harvested using the open and endoscopic techniques. Bisleri and Muneretto [22] in a propensity score analysis including 470 patients found significantly lower incidence of wound infection, significantly lower pain and better wound healing with the endoscopic technique, in the absence of any difference in cardiac-related mortality.…”

Five-Year Clinical Outcome of Endoscopic Versus Open Radial Artery Harvesting: A Propensity Score Analysis

“…Furthermore, the degree of native coronary stenosis as well as the runoff of the target vessels play a critical role in the long-term patency of RA grafts, regardless of the harvesting technique utilized [15,16].…”

How I do it: Endoscope-assisted in situ arterial reconstruction of the lower limb

“… 11 One study suggests that closed systems might be associated with vein graft thrombosis. 12 Modifications can also be made to methods of tributary occlusion, including endoscopic clip application, cautery ligation, and angiographic embolization. 4 , 13 We prefer clip application to reduce the risk of inadvertent injury from thermal spread or endoluminal trauma.…”