Endoscopic or No-Touch Vein Harvesting for CABG: What is Best for the Patient?

Brazilian Journal of Cardiovascular Surgery The saphenous vein (SV) is the most commonly used conduit for coronary artery bypass surgery (CABG)[1], with minimally invasive endoscopic vein harvesting (EVH) being used in the majority of CABG in the USA[2]. While the benefits of EVH include reduced wound complications and improved cosmetic outcome, an inferior patency rate of EVH-SVs compared to those harvested by open vein harvesting (OVH) has been reported[3] (Figure 1). Previous guidance in the United Kingdom advised that EVH should only be used with special arrangements[4]. This decision was based on data from the Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT) IV trial, where EVH-SV grafts showed higher failure rates than OVH grafts and, at 3 years, a higher death rate, myocardial infarction or revascularization compared to OVH grafts[5]. Originally, the PREVENT IV trial Braz J Cardiovasc Surg 2016;31(6):461-4 SPECIAL ARTICLE