Endoscopic vein harvest in lower-extremity bypass—Is it preferable to prosthetic bypass or standard vein harvest?

Abstract

Purpose Endoscopic saphenous vein harvest (EVH) was compared with prosthetic bypass (PB) and open vein harvest (OVH) to determine its impact on short-term complications and long-term patency in lower-extermity bypass(LEB).

Methods Thirty-six patients underwent PB, 19 patients underwent OVH, and 33 patients underwent EVH between March 2003 and July 2004 There were statistically significant differences in the incidence of coronary artery disease, diabetes mellitus, and hypertension among the three groups. Sixty-five percent of total procedures (57/88) were performed for limb salvage. Sixty-eight percent of EVH patient, 79% of OVH patients, and 58% of PB patients underwent bypass for ischemic rest pain or limb salvage.

Results Total 30-day complications or death occurred in 3% EVH , 15.8% OVH, and 16.7% PB (p =0.14). Mean length of stay was 5 days for PB,8 days for OVH and 7 days for EVH (p = 0.39). Mean follow up was 11.5 ± 7.8 months (range-1–30) with a median of 11 months.

Conclusions Thirty-day overall complication rates clinically were less in the EVH group than in the OVH and PB groups. One-year patency and limb salvage were similar in all groups. Length of stay was equivalent in all groups. EVH is a perferred method for saphenous vein harvest because of a decrease in the incidence of perioperative complications and equivalent length of stay and one-year patency.