Neovascularization and other histopathologic findings in an autogenous saphenous vein wrap used for recalcitrant carpal tunnel syndrome: a case report.

A patient suffering from recalcitrant carpal tunnel syndrome despite 4 surgical decompressions was treated successfully with revision carpal tunnel release, neurolysis, and autogenous saphenous vein wrapping of the median nerve. When he subsequently developed compression of the common digital nerve to the middle finger his carpal tunnel was re-explored and the previously applied vein graft underwent a biopsy examination. Histopathologic analysis of the biopsy specimen was remarkable for neovascularization of the vein graft and structural transformation of the vein endothelium, neither of which has been reported in vein wrapping of the upper extremity.