Current status of endoscopic vein harvest in cardiac and peripheral vascular surgery.

Endoscopic harvesting of the saphenous vein (EVH) has been shown to minimize the morbidity associated with saphenous vein harvest for either coronary artery bypass or lower extremity bypass. However, the long-term benefit of a bypass procedure is predicated on conduit patency. Several studies suggest decreased patency with EVH compared with open vein harvest. Possible reasons for this discrepancy have been investigated by microscopic, electron microscopic, and functional studies of venous endothelium and contractile function of harvested veins with conflicting results. This review details the results of these studies. In addition, the clinical results of coronary bypass graft and lower extremity bypass with open vein harvest and EVH are described in regard to early wound complications and short- and long-term patency.