Comparison Of Vascular Damage And Patency Rate Of Great Saphenous Vein With Endoscope And Open Incision

Objective: The saphenous vein as a graft is the most commonly used bridge vessel in coronary artery bypass grafting(CABG).The effect of venous graft collection on clinical outcomes has not been well documented.This study analyzes the effect of endoscopic vein harvesting(EVH)and open vein harvesting(OVH)harvesting of large saphenous veins on the final effect of coronary artery bypass grafting performed by the same main knife doctor.Methods: One doctor performed 27 patients and 16 patients with EVH and OVH,respectively.There were no significant differences in gender,age,BMI,and chronic disease between the two groups.T-test,chi-square test,and linear regression were used to analyze the differences between the two methods,including clinical results,postoperative complications,length of hospital stay and cost,and 64-MSCTA.Results:1.linical outcome indicators:The length of the venous bridge and the number of venous bridge anastomosis of the two surgical approaches were close to each other without cases of tunnel skin necrosis.The frequency of vascular injury in the EVH group was 22%,but there was no significant difference compared with the OVH group;2.Postoperative complications,EVH and OVH,occurred in hematoma or subcutaneous stasis,incision infection,fat liquefaction,incision dehiscence,and lymphangitis.Lower extremity edema,EVH incidence was 37%.The rate was 75%,and a significant difference was reached between the two(P = 0.016).Wound pain or numbness occurred in the EVH group were zero,and the OVH incidence rate was 62.5%,a significant difference was reached between the two groups(P = 0.000);3.Postoperative hospitalization time and cost:The hospitalization time,hospitalization cost,and bedtime were higher in the OVH group than in the EVH group,but they did not reach significance;4.64-MSCTA examination results showed that the number of venous bridge anastomosis / branch,aortic anastomosis stenosis,coronary anastomosis,hemangioma-like dilation did not differ significantly between the two groups,and venous thrombus OVH was significantly higher than EVH Group(P = 0.024),the patency rate of EVH was significantly higher than that of OVH group(P = 0.037).Conclusions: EVH method can reduce the incidence of lower limb edema,lower limb numbness / pain,reduce the incidence of venous thrombosis,and significantly increase the patency of the blood vessels when obtaining the same length of venous bridge and the number of venous bridge anastomosis.Therefore,it is recommended to use more EVH schemes if conditions permit.