Endoscopic and traditional saphenous vein harvest: A histologic comparison

Background. Vein trauma after saphenectomy by endoscopic or longitudinal te chniques may influence the progression of medial and intimal hyperplasia an d ultimately affect graft patency. This study compared the histologic chara cteristics of saphenous veins after endoscopic and longitudinal harvest. Methods. One hundred seventy patients who underwent elective coronary arter y bypass grafting had saphenectomy performed endoscopically (n = 88) or by a longitudinal incision (n = 82). Cross-sectional specimens from endoscopic ally (n = 151) and longitudinally (n 158) harvested Veins were submitted fo r hematoxylineosin, trichrome, and elastin staining. Blinded histologic eva luation involved graded analysis of endothelial, smooth muscle, and elastic lamina continuity in addition to medial and adventitial connective tissue uniformity. Results. Regardless of harvest technique, endothelial, elastic lamina, and smooth muscle continuity as well as medial and adventitial connective tissu e uniformity were not significantly different. Conclusions. Minor histologic alterations occur during saphenectomy, howeve r, endoscopically and longitudinally harvested saphenous veins are histolog ically similar. (C) 2000 by The Society of Thoracic Surgeons.