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TITLE:
Long Term Evaluation of Endoscopically Harvested Saphenous Vein for Lower Extremity Bypass
OBJECTIVE:
To evaluate the perioperative complications and long term patency of endoscopically harvest
saphenous vein for lower extremity bypass.
METHODS:
This is a retrospective review of patients who underwent femoral popliteal (F.P.) bypass (above knee and below knee) and femoral tibial (F.T.) bypass between February 2003 and November 2011. All veins were harvested by physician assistants experienced in endoscopic vein harvest.
Categorical variables were presented as proportions and continuous variables as mean ± sd. Two sample t-test and Fisher’s exact test were used to compare the group differences. Kaplan-Meier survival analysis was performed to compare differences in patency between FP and FT groups.
RESULTS:
91 patients underwent either FP (#58) or FT(#33) bypass between February 2003 - November 2011. Demographics are given. Table I
DEMOGRAPHICS
F.P. #58
F.T. #33
p value
Male/Female (%)
65/35
61/39
0.6567
Age (years)
66.29 ± 10.61
72.2 ± 9.95
0.0101
Hypertension (%)
67%
76%
0.4618
Cardiac Disease (%)
33%
41%
0.4780
Smoking History (%)
60%
43%
0.1743
INDICATION (%)
Claudication
41%
3%
<.0001
Rest Pain
33%
32%
Tissue Loss
26%
66%
There were three superficial infections and one deep infection. No patient required graft removal for infection. There was one perioperative mortality.
Primary patency at 5 years was 68% for F.P. and 56% for F.T. (log-rank p-value = 0.1925).
CONCLUSION:
Long term results for LEB with endoscopically harvested vein is associated with low incidence of perioperative morbidity and mortality. Long term results appear to be comparable to standard methods of vein harvest.