Long saphenous vein harvesting techniques and their effect on graft patency

Abstract

Coronary artery bypass grafting is a key cardiac surgery procedure and is the main treatment for patients with multivessel coronary artery disease. The most frequently used conduit for this procedure is the long saphenous vein (LSV). The technique of harvesting the LSV has evolved over the last 30 years from total open harvesting to endoscopic with minimal access technique. The most important determining factor for success in coronary artery surgery is the graft patency rate. The literature evidence behind each technique has been reported at different levels and there is an ongoing debate about which technique can provide optimum vein patency over the long term. This literature review aims to summarize the current evidence, the implications involved with the use of each technique for harvesting LSV and the patency rate at variable follow‐up intervals.

Safety of limb-salvaging surgery for sarcomas compromising major vessels: A 15-year single-centre outcomes study.

“…The long saphenous vein presents the benefits of being easily accessible in the thigh and being able to provide long grafts of adequate calibre for reconstructing major vessels 14 . Care must be taken to reverse the orientation of venous grafts for reconstructing arteries, along with avoiding twists, kinks and vessel redundancy during the inset that might compromise patency 15 .…”

Comparison of the Outcomes after Endoscopic Vein Harvesting Versus Open Vein Harvesting for Coronary Bypass Surgery

“…The reduction of vein graft patency from twelve months onward was reported significantly with the endoscopic harvesting technique [17]. However, a recent study by Harky, et al in demonstrated that EVH will offer patency rates similar to the OVH when the grafts are harvested by highly experienced harvesters [18]. Many studies consistently reported a close and strong association between graft patency and target vessel status, to justify this claim, Gaudino, et al reported that a crucial factor affecting the long-term patency of the graft, which is the target vessel diameter.…”

High-flow bypass using saphenous vein grafts with trapping of ruptured blood blister-like aneurysms of the internal carotid artery: patient series

“…20,22 (2) A greater length of the saphenous vein can be harvested compared with the radial artery. 23 (3) They have a higher feasible flow rate (70-140 mL/min) than RAGs (70 mL/min) and are therefore more suitable for the requirements of cerebral blood flow. 19 (4) They rarely cause vasospasms, whereas RAGs are more prone to vasospasms (4%-10%), which may result in ischemic sequelae.…”