ASSESSMENT OF HUMAN LONG SAPHENOUS-VEIN FUNCTION WITH MINIMALLY INVASIVE HARVESTING WITH THE MAYO STRIPPER

Background: The use of the Mayo Stripper to harvest the long saphenous vein has been shown to improve morbidity from leg wound incisions. It has not been universally accepted because of a perceived increase in injury to the venous conduit. Objective: Tn compare the function of un distended autologous long saphenous vein harvested by a Mayo stripper with the traditional 'open technique in the same patient (n = 12) appe arance. Methods: Vascular reactivity was assessed in isolated organ ba ths. Contractile function was measured in response to increasing conce ntrations (10(-9)-10(-5) mol) of 5-hydroxytryptamine and noradrenaline , This was calculated as a percentage of the maximum contractile respo nse to 90 mM KCl measured in millinewtons (mN) (control 41.4 +/- 12.1, (n = 11), open technique 35.8 +/- 11.1, (n = 11), Mayo stripper 33.7 +/- 15.9, (n = 11)). The endothelial dependent and independent functio n was assessed with acetylcholine and sodium nitroprusside, respective ly. Results: There was no significant difference in response to both c onstrictors and dilators between vein taken with the Mayo stripper com pared with the traditional open technique (n = 6 for each observation; P > 0.05 by ANOVA). Histological examination by light microscopy of t he vessel segments removed with the Mayo stripper was unable to show a ny significant damage to the vessel wall. Both functional and morpholo gical studies were conducted by 'blinded' observers. One-year follow-u p with magnetic resonance angiography (MRA) and stress thallium tomogr aphy demonstrated a patency rate with lower and upper estimates of 80 and 94%. Conclusion: We have shown that harvesting the long saphenous vein with a Mayo stripper does not compromise vascular reactivity of t he long saphenous vein or long-term patency. (C) 1997 Elsevier Science B.V.