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DOI: 10.1055/s-0032-1332682
Endoscopic vein harvesting: Patient characteristics influencing its application
Objective: The standard of care regarding endoscopic vein harvesting (EVH) is still inhomogeneous across Europe. The current study aims at elucidating patient-related factors for EVH application in a tertiary care center.
Methods: All patients who underwent CABG between 2008 – 2011 were included. Emergency surgery and all arterial revascularisation patients were excluded.
Results: A total of 268 EVH patients and 629 open vein harvested patients were included. Mortality, perfusion time and cross-clamp time were not significantly different.
The linear EuroSCORE was lower for EVH (5.7 ± 3.3 vs. 6.4 ± 3.3; p = 0.01). Women and patients with peripheral artery disease were less likely offered EVH (23% vs. 31%; p = 0.012 and 16% vs. 25%; p = 0.006). On the contrary, patients with diabetes were more frequently treated with EVH (44% vs. 35%; p = 0.008).
For EVH, the number of diseased vessels (2.7 vs. 2.5; p = 0.001) as well as the number of bypass grafts (arterial: 1.0 vs. 0.9; p = 0.016, venous 2.0 vs. 1.7; p < 0.001) were significantly increased. Minor wound healing problems were more common in the open group (10.3% vs. 3.8%; p = 0.001). Significant leg complications requiering revision occured in 2.4% of open vein harvested patients compared to 1.1% for EVH patients (p = ns).
Conclusions: EVH is favoured in diabetic patients. Female gender and peripheral artery disease lead to a decreased application of EVH. Interestingly, patients in our center with a higher number of bypass grafts were more likely to receive EVH. Favourable outcome of EVH should result in a more widespread use of this technology.