Endoscopic vein harvest for infrainguinal arterial bypass

Abstract

Endoscopic and open harvest techniques for infrainguinal arterial bypass provide similar rates of wound complications and bypass patency, whereas hemodialysis negatively affects patency after both harvest methods. Endoscopic harvest is associated with the need for less perioperative narcotics, suggesting a potential benefit of endoscopic harvest that deserves further study.

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.…”

“…Although our overall wound complication rate of 43% in the OVH group seems high, it includes all complications including Szilagyi I, and it is not too dissimilar from the previous reported rates in series from single academic centers (23%-44%). 10,11,15,19 Our study also found that both BMI and prior surgery were independently associated with wound complications. The relationship between increased BMI and surgical wound complications has been demonstrated in several previous studies.…”

Endoscopic Vein Harvesting in Lower Extremity Arterial Bypass: A Systematic Review

“…31 One presentation abstract 32 was also excluded as the results were further published as a research paper. 33 There were no randomised control studies, and 12/18 were single-centre comparative (cohort) studies. 19e21,33e41 Only one of these was a prospective design.…”

Vein harvesting technique for infrainguinal arterial bypass with great saphenous vein and its association with surgical site infection and graft patency

“…23 However, another large retrospective study demonstrated that endoscopic vein harvesting was associated with decreased long-term mortality (AHR, 0.74; 95% CI, 0.60-0.92; P ¼ .007). 24 The cardiac literature has also demonstrated in a randomized controlled trial that endoscopic harvesting is 7 The use of the minimally invasive strategy for vein harvesting was also not associated with improved wound outcomes according to a recent meta-analysis. 26 The findings of this present study are consistent with the results of the meta-analysis as well as our singleinstitution study.…”

“…26 In studies in which the primary patency beyond 1 year is reported, several have demonstrated a significantly higher rate of delayed patency loss for the grafts harvested endoscopically. [13][14][15][16] In two of three studies that we identified reporting comparable delayed primary patency rates for open and endoscopic harvest techniques, 5,7,12 all the endoscopic harvesting procedures were performed by a single surgeon. 5,7 A fundamental component for the successful application of this technology is the commitment and experience of the operator performing the endoscopic vein harvesting.…”