Objective: To compare the 6-month angiographic patency of endoscopically (E) harvested saphenous veins to that of the traditional open (O) technique.
Methods: Two hundred patients undergoing non-emergent on-pump CABG were prospectively randomized to O or E. Six-month angiographic graft patency and disease grades were assigned by two 'blinded' cardiologists. Preoperative patient characteristics and quality of vein and target vessels were entered into a hierarchical logistic regression analysis to determine the predictors of graft closure.
Results: There were 2 peri-operative deaths (both E) and 2 late deaths (1 O and 1 E). Twenty-seven O patients and 25 E patients could not be reached or refused follow-up angiography. There were 170 O grafts (2.4 per patient) and 166 E grafts (2.3 per patient) available for analysis. Overall closure rates were 17.6% for O and 21.7% for E, for a univariate odds ratio (OR) of 1.3 (95% confidence interval [CI] 0.7 - 2.4). There was evidence of disease in an additional 12.4% O grafts and 10.2% E grafts. Significant variables (OR) for graft occlusion were larger graft size (1.4), congestive heart failure (3.1), greater graft flow (0.9) and right coronary system target vessel (0.5). After adjusting for these factors, the OR (CI) for graft closure associated with endoscopic harvesting was 1.2 (0.6-2.6).
Conclusion: This study suggests that the overall graft patency rate depends on patient factors as well as target and vein-related variables rather than the method of vein harvesting . Therefore, endoscopic vein harvesting is a safe technique without compromising graft integrity.

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