Abstract:Objectives
Endoscopic vein harvest (EVH) has been demonstrated to improve early morbidity when compared with conventional open harvest technique (OVH) for infrainguinal bypass surgery. However recent literature suggests conflicting results regarding mid and long-term patency with EVH. The purpose of this study is to compare graft patency between harvest techniques specifically in patients with critical limb ischemia (CLI).
Methods
This retrospective study compared two groups of patients (EVH=39 and OVH=49) u… Show more
“…This was also reflected in the multivariate analysis, which identified OVH as an independent risk factor for wound complications. Our findings are similar to the report of Eid et al, 10 who showed that 20% of the open harvest group had vein harvest site complications, whereas there were none in the endoscopic group (14.5% vs 0% in our study). Similarly, Santo et al 11 also showed a significant difference in the vein harvest site complication rates (29.1% vs 11.8%) between the two techniques, although the overall wound complication rates were similar (44.4% vs 36.7%).…”
Section: Discussionsupporting
confidence: 92%
“…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.…”
Section: Discussionsupporting
confidence: 73%
“…One of the concerns is inferior patency and increased rates of reinterventions associated with EVH. [10][11][12][13][14]16 Our study shows that in experienced hands, EVH is associated with similar graft patency, reintervention rates, and limb salvage and fewer harvest site complications.…”
Section: Discussionmentioning
confidence: 95%
“…7 However, EVH has been used less frequently in lower extremity bypass surgery, with studies showing variable results in terms of wound complications. [8][9][10][11][12][13][14][15][16] Moreover, there is concern about inferior patency and increased reinterventions with EVH compared with OVH. [10][11][12][13][14]16 A recent meta-analysis of series between 1996 and 2013 on EVH revealed not only decreased patency rates in the EVH groups but also no advantage in wound complication rates.…”
mentioning
confidence: 99%
“…14 However, two other series from high-volume academic centers found significant decrease in wound complications with decreased primary patency but comparable limb salvage rates. 10,11 We started using EVH in 2008 in collaboration with our cardiac surgery physician assistant with extensive experience in this technique mainly because of our dissatisfaction with harvest site wound complications and a few early in situ vein graft occlusions for unclear reasons. EVH became our preferred approach shortly after we started using this technique.…”
In experienced hands, EVH is associated with a significant decrease in wound complications with similar graft patency, reintervention rates, and limb salvage.
“…This was also reflected in the multivariate analysis, which identified OVH as an independent risk factor for wound complications. Our findings are similar to the report of Eid et al, 10 who showed that 20% of the open harvest group had vein harvest site complications, whereas there were none in the endoscopic group (14.5% vs 0% in our study). Similarly, Santo et al 11 also showed a significant difference in the vein harvest site complication rates (29.1% vs 11.8%) between the two techniques, although the overall wound complication rates were similar (44.4% vs 36.7%).…”
Section: Discussionsupporting
confidence: 92%
“…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.…”
Section: Discussionsupporting
confidence: 73%
“…One of the concerns is inferior patency and increased rates of reinterventions associated with EVH. [10][11][12][13][14]16 Our study shows that in experienced hands, EVH is associated with similar graft patency, reintervention rates, and limb salvage and fewer harvest site complications.…”
Section: Discussionmentioning
confidence: 95%
“…7 However, EVH has been used less frequently in lower extremity bypass surgery, with studies showing variable results in terms of wound complications. [8][9][10][11][12][13][14][15][16] Moreover, there is concern about inferior patency and increased reinterventions with EVH compared with OVH. [10][11][12][13][14]16 A recent meta-analysis of series between 1996 and 2013 on EVH revealed not only decreased patency rates in the EVH groups but also no advantage in wound complication rates.…”
mentioning
confidence: 99%
“…14 However, two other series from high-volume academic centers found significant decrease in wound complications with decreased primary patency but comparable limb salvage rates. 10,11 We started using EVH in 2008 in collaboration with our cardiac surgery physician assistant with extensive experience in this technique mainly because of our dissatisfaction with harvest site wound complications and a few early in situ vein graft occlusions for unclear reasons. EVH became our preferred approach shortly after we started using this technique.…”
In experienced hands, EVH is associated with a significant decrease in wound complications with similar graft patency, reintervention rates, and limb salvage.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.