scholarly journals Lens assisted after Duplex mapping, Bridging technique of saphenous vein harvesting. (A new technique in saphenous vein harvesting, best substitute for endoscopic vein harvesting)

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Ali Ali Mohamed Elbassioni
Keyword(s):  
Saphenous Vein ◽  
New Technique ◽  
Endoscopic Vein Harvesting ◽  
A New Technique ◽  
Bridging Technique ◽  
Vein Harvesting

A Novel Technique of Endoscopic Vein Harvesting With Preserved Perivascular Tissue

2020 ◽  
Vol 15 (5) ◽  
pp. 475-477
Author(s):  
Kunihiko Yoshino ◽  
Kohei Abe ◽  
Koyu Suzuki ◽  
Rihito Tamaki ◽  
Atusyuki Mituishi ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Histopathological Examination ◽  
Wound Complications ◽  
Connective Tissues ◽  
Endoscopic Vein Harvesting ◽  
Harvesting Technique ◽  
A New Technique ◽  
Vein Harvesting ◽  
The Ideal

The no-touch saphenous vein harvesting technique is considered to be the ideal procedure to achieve the best quality of vein, whereas the endoscopic vein harvesting (EVH) technique is considered to be ideal for decreasing wound complications. We developed a new technique of EVH with perivascular tissue preservation. This procedure was performed by dissecting the immediate anterior and posterior perivascular connective tissues of the saphenous vein followed by cutting approximately 1 cm laterally from the saphenous vein with the use of a harvester (MAQUET Getinge Group, Getinge AB, Göteborg, Sweden). Histopathological examination revealed preserved perivascular tissue and intimal folding.

Abstract P158: Long-Term Outcomes of Endoscopic Vein Harvesting After Coronary Artery Bypass Grafting

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Lawrence Dacey ◽  
John Braxton ◽  
Robert Kramer ◽  
Joseph Schmoker ◽  
David Charlesworth ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Endoscopic Vein Harvesting ◽  
Repeat Revascularization ◽  
Risk Of Mortality ◽  
Vein Harvesting

Introduction: Endoscopic saphenous vein harvesting has developed into a standard of care at many cardiothoracic surgical centers. The association between this technique and long-term morbidity and mortality has recently been called into question. We describe the association between use of open versus endoscopic vein harvesting and the risk of mortality and repeat revascularization within northern New England during a time period (2001-2004) in which both techniques were being performed. Methods: Prospective cohort study. From 2001-2004, 52.5% (4,485 of 8,542) of patients undergoing isolated coronary artery bypass grafting surgery had their saphenous vein harvested endoscopically. Surgical discretion dictated the vein harvest approach. Results: Use of endoscopic vein harvesting increased from 34% (781 of 2,291) in 2001 to 75% (1,341 of 1,792) in 2004. Patients undergoing endoscopic vein harvesting had greater disease burden. Endoscopic vein harvesting was associated with a significant reduction in long-term mortality [adjHR: 0.79, (CI 95% 0.68, 0.91)] and risk of repeat revascularization or mortality [adjHR: 0.87, (CI 95% 0.78, 0.98), Figure]. Endoscopic vein harvesting was associated with a non-significant increased risk of repeat revascularization [adjHR: 1.08, (CI 95% 0.89, 1.31)]. Similar results were obtained in a propensity-matched analysis. Conclusion: The use of endoscopic vein harvesting was associated with a reduced risk of mortality as well as a composite endpoint of mortality or repeat revascularization four years after the index admission. This practice insignificantly increased the risk of repeat revascularization.

scholarly journals A Prospective Audit of Endoscopic Vein Harvesting for Coronary Artery Bypass Surgery

2009 ◽  
Vol 91 (5) ◽  
pp. 426-429 ◽  
Author(s):  
Zakariya Waqar-Uddin ◽  
Manoj Purohit ◽  
Nadene Blakeman ◽  
Joseph Zacharias
Keyword(s):  
Patient Satisfaction ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Coronary Artery Bypass Surgery ◽  
Artery Bypass ◽  
Prospective Audit ◽  
Endoscopic Vein Harvesting ◽  
Long Saphenous Vein ◽  
Vein Harvesting

INTRODUCTION The objectives of this study were to: (i) assess the feasibility of minimally invasive endoscopic harvesting of the long saphenous vein or radial artery for use as conduit during coronary artery bypass surgery in the NHS setting; and (ii) investigate the results of endoscopic vein harvesting with regards to postoperative complications, ability to mobilise, and patient satisfaction. PATIENTS AND METHODS In this prospective audit, 25 consecutive patients, aged 52–90 years, undergoing either coronary artery bypass grafting alone or together with valve surgery or atrial fibrillation ablation were studied. All data were entered in purpose-designed proforma. Pre-operative risk factors including increasing age, diabetes, peripheral vascular disease, obesity, renal impairment, tobacco consumption and steroid use were documented. Time taken for harvest and conversion to traditional open vein harvest, quality of harvested vein in terms of number of repairs and vein damage were recorded. Postoperatively, we recorded harvest site wound complications, number of days to mobilise and total hospital stay. Pain score and patient satisfaction were also assessed. RESULTS There was one death due to myocardial infarction; another patient had postoperative cerebrovascular accident. A total of 43 lengths of grafts were harvested, 41 were long saphenous vein and two radial artery. Vein harvest time reduced significantly from a maximum of 94 min to 34 min for two lengths of long saphenous vein. Three patients required conversion from endoscopic vein harvesting to open vein harvest. The only postoperative complication directly related to endoscopic harvesting was bruising along the tunnel created by the passage of the instruments. None of the patients had any wound complication; none required antibiotics or wound debridement. Mean time to mobilise was 3.4 days. All patients who underwent successful endoscopic vein harvesting expressed satisfaction with regards to postoperative pain and cosmetic result. CONCLUSIONS Competence and ability to harvest conduit in an acceptable time frame are obtainable after a relatively low number of cases. The procedure is associated with a low number of postoperative complications and very high patient satisfaction.

scholarly journals A new technique for rapid saphenous vein-coronary artery anastomoses

1971 ◽  
Vol 62 (6) ◽  
pp. 837-843 ◽  
Author(s):  
F. Beachley Main ◽  
David C. Fecht ◽  
Sang Bock Park ◽  
Gerald E. McGinnis ◽  
George J. Magovern
Keyword(s):  
Coronary Artery ◽  
Saphenous Vein ◽  
New Technique ◽  
A New Technique

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

2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Mohammad Hassan Nezafati ◽  
Pouya Nezafati ◽  
Sakineh Amoueian ◽  
Armin Attaranzadeh ◽  
Hamid Reza Rahimi
Keyword(s):  
Saphenous Vein ◽  
Endoscopic Vein Harvesting ◽  
Vein Harvesting

An Artificial Cadaveric Leg Blood Flow System for Endoscopic Vein Harvesting Simulation

2017 ◽  
Vol 12 (5) ◽  
pp. e16-e18 ◽  
Author(s):  
Constantine L. Karras ◽  
Emily A. DeDonato ◽  
Kaitlin K. DiBartola ◽  
Jin-Cheng Zhao
Keyword(s):  
Blood Flow ◽  
Saphenous Vein ◽  
Flow System ◽  
Training Model ◽  
Surrounding Tissue ◽  
Medial Malleolus ◽  
Bipolar Coagulation ◽  
Artificial Blood ◽  
Endoscopic Vein Harvesting ◽  
Vein Harvesting

Despite being the most common training model for endoscopic vein harvesting, cadaveric legs are limited by their absence of blood flow, resulting in a faded vascular appearance. Because the saphenous vein and the surrounding tissue seem less distinguishable, dissection of the saphenous vein and bipolar coagulation of its branches becomes increasingly inefficient and difficult. An inexpensive artificial blood flow system was developed to overcome this limitation. A cadaveric leg was thawed to a soft and yielding degree, and the saphenous vein was dissected medial and proximal to the medial malleolus. An artificial blood solution was prepared by dissolving 4% protein powder, red dye, and a contrast agent—for x-ray visualization—in saline. The solution was perfused through the saphenous vein and artery. The open ends of the vessels were temporarily clamped after the perfusion had been completed. Blood flow within the vessels was confirmed via angiography and endoscopic visualization of the leg's vessels. A bleeding effect was observed when the saphenous vein was perforated or when a vascular branch was transected. Conversely, a tight seal indicated successful bipolar coagulation of a branch, providing an objective, quantifiable assessment parameter. The artificial blood flow system helps overcome the limitations of the cadaveric leg, creating a more realistic and inexpensive model for endoscopic vein harvesting simulation training.

scholarly journals Video-assisted saphenous vein harvest: The evolution of a new technique

1997 ◽  
Vol 26 (3) ◽  
pp. 405-414 ◽  
Author(s):  
William D. Jordan ◽  
David C. Voellinger ◽  
Per T. Schroeder ◽  
Holt A. McDowell
Keyword(s):  
Saphenous Vein ◽  
New Technique ◽  
Video Assisted ◽  
A New Technique

One-shot scleroembolization: a new technique for the treatment of varicose veins disease of lower extremities. Preliminary results

2013 ◽  
Vol 29 (10) ◽  
pp. 694-697 ◽  
Author(s):  
Marco P Viani ◽  
Giacomo M Viani ◽  
Jessica Sergenti
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Lower Extremities ◽  
New Technique ◽  
Invasive Treatment ◽  
Effective Technique ◽  
Combined Use ◽  
A New Technique

Objective The aim of this article is to present a new technique for minimally invasive treatment of varicose veins disease of lower extremities. Methods One-shot scleroembolization is a new technique designed for the treatment of varicose veins of the lower extremities, which associates a mechanical interruption of the sapheno-femoral junction to classic sclerotherapy with no need for surgery or anesthesia. This is achieved with the combined use of a coil positioned in the terminal portion of the great saphenous vein and a foamed sclerosant drug. Results At three months’ follow-up no complications have been observed. The great saphenous vein was still occluded in all patients (nine out of nine). Conclusions One-shot scleroembolization seems to be an effective technique for the treatment of varicose veins disease in outpatients, with the advantage of causing little distress to the patient.

scholarly journals Predictive value of great saphenous vein mapping prior to endoscopic harvesting in coronary artery bypass surgery

2020 ◽  
Vol 31 (1) ◽  
pp. 16-19
Author(s):  
Ferdi Akca ◽  
Ka Yan Lam ◽  
Niels Verberkmoes ◽  
Ignace de Lathauwer ◽  
Mohamed Soliman-Hamad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Predictive Value ◽  
Great Saphenous Vein ◽  
Artery Bypass ◽  
Endoscopic Vein Harvesting ◽  
Preoperative Mapping ◽  
Coronary Bypass Grafts ◽  
Vein Harvesting

Abstract OBJECTIVES The use of endoscopic vein harvesting in patients undergoing coronary artery bypass grafting is increasing, often using bedside mapping. However, data on the predictive value of great saphenous vein (GSV) mapping are scarce. This study assessed whether preoperative mapping could predict final conduit diameter. METHODS A prospective registry was created that included 251 patients. Saphenous vein mapping was performed prior to endoscopic vein harvesting at 3 predetermined sites. After harvesting and preparing the GSV, the outer diameters were measured. Appropriate graft size was defined as an outer diameter between 3 and 6 mm. RESULTS A total of 753 GSV segments were analysed. The average mapping diameter was 3.2 ± 0.7 mm. The harvested GSV had a mean diameter of 4.7 ± 0.8 mm. Mapping diameters were significantly positively correlated with actual GSV diameters (correlation coefficient, 0.47; P < 0.001). If the preoperative mapping diameters were between 1.5 and 5 mm, 96.6% of the GSVs had suitable dimensions after endoscopic vein harvesting. CONCLUSIONS Preoperative bedside mapping moderately predicts final GSV size after endoscopic harvesting but could not detect unsuitable vein segments. However, the majority of endoscopically harvested GSVs had diameters suitable to be used as coronary bypass grafts.

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