Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium

Nezafati, Mohammad Hassan; Nezafati, Pouya; Amoueian, Sakineh; Attaranzadeh, Armin; Rahimi, Hamid Reza

doi:10.1186/1749-8090-9-101

Cited by 16 publications

(23 citation statements)

References 21 publications

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“…[10][11][12] Five studies were excluded because no usable data were reported. [13][14][15][16][17] One study was excluded because both saphenous vein and radial artery harvest were used without reporting separate results for each type of harvest. 18 One study was excluding for using a bridging technique that was not considered to be true endoscopic harvest.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Conduit Harvest in Coronary Artery Bypass Grafting Surgery

Ferdinand

MacDonald

Balkhy

et al. 2017

Innovations�(Phila)

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Objective The purpose of this consensus conference was to develop and update evidence-informed consensus statements and recommendations on harvesting saphenous vein and radial artery via an open as compared with endoscopic technique by systematically reviewing and performing a meta-analysis of randomized and nonrandomized clinical trials. Methods All randomized controlled trials and nonrandomized controlled trials included in the first the International Society for Minimally Invasive Cardiothoracic Surgery Consensus Conference and Statements,1,2 in 2005 up to November 30, 2015, were included in a systematic review and meta-analysis. Based on the resultant, 76 studies (23 randomized controlled trials and 53 nonrandomized controlled trials) on 281,459 patients analyzed, consensus statements, and recommendations were generated comparing the risks and benefits of endoscopic versus open conduit harvesting for patients undergoing coronary artery bypass grafting. Results Compared with open vein harvest, it is reasonable to perform endoscopic vein harvest of saphenous vein to reduce wound-related complications, postoperative length of stay, and outpatient wound management resources and to increase patient satisfaction (class I, level A). Based on the quality of the conduit and major adverse cardiac events as well as 6-month angiographic patency, endoscopic vein harvest was noninferior to open harvest. It is reasonable to perform endoscopic radial artery harvest to reduce wound-related complication and to increase patient satisfaction (class I, level B-R and B-NR, respectively) with reduction in major adverse cardiac events and noninferior patency rate at 1 and 3 to 5 years (class III, level B-R). Conclusions Based on the consensus statements, the consensus panel recommends (class I, level B) that endoscopic saphenous vein and radial artery harvesting should be the standard of care for patients who require these conduits for coronary revascularization.

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Section: Resultsmentioning

confidence: 99%

Endoscopic Conduit Harvest in Coronary Artery Bypass Grafting Surgery

Ferdinand

MacDonald

Balkhy

et al. 2017

Innovations�(Phila)

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“…Unexpectedly, our results showed that the vsO technique is better than the vsE technique. According to the previous research [14,15,20], we expected equal or more significant loss of endothelial cells in the vsE than in the vsO group as the endoscopic method causes more mechanical stress to the vessels than the open method. This result may be due to the small number of veins, especially in the vsE group -which is the main weakness of our study, and/or due to some unknown mechanisms.…”

Section: Discussionmentioning

confidence: 90%

“…A possible explanation for a higher rate of graft failure when using the endoscopic technique could be endothelial damage caused by greater mechanical stress during the harvesting procedure. The endoscopic and open techniques were therefore compared according to viability and the morphologic damage of saphenous vein endothelium [14,15]. 2 www.bjbms.org Immediately after harvesting, using either the endoscopic or open technique, it was found that endothelial cells were firmly attached to the tunica intima.…”

Section: Introductionmentioning

confidence: 99%

Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery

Milutinović

Zorc-Pleskovič

2020

Bosn J of Basic Med Sci

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The patency of the vein graft in coronary artery bypass grafting could be dependent on the conventional open (vsO) or endoscopic (vsE) harvesting and on the hypoxic damage of endothelial cells. We aimed to evaluate both surgical techniques according to endothelial loss that occurs in the time between harvesting and implantation. Twenty-six saphenous veins were divided into vsO (n = 16) and vsE (n = 10) group. Three samples were taken from each vein. The first sample was taken after removal, the second before implantation of the distal part, and the third before the implantation of the proximal part, and they were stained with HE, Movat, and immunohistochemically with CD31. A significant loss of endothelial cells within both groups was found at the time of implantation of the distal and the proximal part of the vein graft compared to the endothelial cells at the time of harvesting. There were no significant differences in the endothelial loss between vsE and vsO groups at the time of harvesting and at the time before the implantation of the distal part. A higher number of endothelial cells was found in vsE group compared to vsO group at the time just before the implantation of the proximal part. The comparison of the implanted portions of vsE and vsO grafts to mammary arteries revealed a significant loss of endothelial cells only in vsO graft. We conclude that, at the time of implantation, the endothelial layer of the vein graft harvested endoscopically is more preserved than of the vein graft harvested openly.

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“…Multiple studies within the cardiac literature suggested not only clinically comparable outcomes with similar patency rates but also histologic findings that show no difference in vessel wall integrity in harvested segments used for CABG. 16,17 Yet other results stated that EVH for CABG has detrimental effects on the structural viability of the endothelium 18,19 and furthermore has inferior patency rates. 20 Opportunity for endothelial compromise potentially increases as the length of required vein segment does, which is a possible basis for the generalized acceptance of EVH for CABG and the skepticism of its application in the lower extremity.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 99%