Angioscopic Preparation of the Saphenous Vein for in situ Grafting in the Treatment of Chronic Lower Extremity Ischemia

Abstract

The purpose of this study is to evaluate the angioscopic method of preparation of the saphenous vein for in situ grafting as compared with the standard open vein preparation. Nineteen consecutive cases performed after adoption of a semiclosed angioscopic technique were compared with 20 consecutive cases performed with the conventional technique of vein preparation. Wound complications occurred less frequently in the angioscopy group (37% vs 78%, p=0.02). By univariate analysis, wound healing problems were associated with low preoperative ankle-brachial index (p=0.07), tissue loss (p=0.05), and use of a long, continuous leg incision (p=0.01). Logistic regression analysis identified low preoperative ankle-brachial index (p=0.03), diabetes (p=0.05), and a long, continuous leg incision (p=0.06) as independent predictors of wound compli cations. Patients with wound complications had significantly longer hospital stays (9 ±8 vs 4 ±3 days, p<0.01). This initial experience suggests that angioscopic preparation of the saphenous vein results in fewer wound complications and should result in shorter hospital stays compared to conventional methods of vein preparation. The long-term effect of angioscopically assisted vein preparation remains to be determined.

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