Endoscopic versus open saphenous vein harvest for femoral to below the knee arterial bypass using saphenous vein graft

Abstract

Despite our initial concerns of damaging the venous conduit with a minimally invasive approach to saphenous vein harvest, EVH in our experience has resulted in a trend toward improved patency rates and decreased infectious wound complications while affording the benefit of improved cosmesis. An endoscopic approach results in smaller incisions, decreased interventions for occlusion, and improved outcomes compared with OVH. EVH is the procedure of choice for harvesting saphenous vein for femoral to below the knee arterial bypass surgery.

Endoscopic vein harvest does not negatively affect patency of great saphenous vein lower extremity bypass

“…We showed that patency and reintervention rates were similar between the two groups, and this held out in subgroup analysis as well, when nonreversed and reversed conduits were compared and found to have comparable patency rates. In this respect, our findings are similar to reports by Wartman et al 19 and Gazoni et al,32 who showed similar patency between the two techniques. In our study, 36% of EVH patients underwent femoral endarterectomy, indicating proximal disease that was simultaneously treated.…”

Ultrasonic vein mapping prior to infrainguinal autogenous bypass grafting reduces postoperative infections and readmissions

“…Yet, the operative trauma through extensive undermining of the skin in an ischemic leg is substantial, and no reduction of wound complications or LOS has been reported. 23 The study revealed a significant increase in overall SSIs at the site of exposure for the proximal anastomosis in group B patients (P ϭ .041). We believe this difference is not correlated with the use of preoperative DVM, because most of the proximal anastomoses were performed in the groin, where preoperative DVM does not play a major role in preventing SSI.…”

The use of minimally invasive videoscopic technique in large vessel and cardiac surgery. Does the potentially increased difficulty bring benefits to the patient?

“…The less ischemic leg, with less marked trophic changes, was selected for endoscopic surgery. There are few publications on the use of endoscopic techniques to harvest the saphenous vein in vascular surgery, in contrast to the fairly frequent application in cardiac surgery [7]. …”