Angioscopic preparation of the saphenous vein for in situ grafting in the treatment of chronic lower extremity ischemia

The purpose of this study is to evaluate the angioscopic method of preparat ion of the saphenous vein for in situ grafting as compared with the standar d open vein preparation. Nineteen consecutive cases performed after adoptio n of a semiclosed angioscopic technique were compared with 20 consecutive c ases performed with the conventional technique of vein preparation. Wound c omplications occurred less frequently in the angioscopy group (37% vs 78%, p = 0.02). By univariate analysis, wound healing problems were associated w ith 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 regressi on analysis identified low preoperative ankle-brachial index (p = 0.03), di abetes (p = 0.05), and a long, continuous leg incision (p = 0.06) as indepe ndent predictors of:wound complications. 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 saph enous vein results in fewer wound complications and should result in shorte r hospital stays compared to conventional methods of vein preparation. The long-term effect of angioscopically assisted vein preparation remains to be determined.