title: "No-touch" versus "endo" vein harvest: early patency on symptom-directed catheterization and harvest site complications.
abstract: OBJECTIVE
  "No-touch" (NT) saphenous vein harvesting preserves the adventitial vasa vasorum, prevents medial ischemia, and is associated with an improved short-term and long-term vein graft patency. It may also be associated with a higher rate of harvest site complications. Endovascular vein harvesting (endo-vein) has a low rate of harvest site complications but also a tendency toward a lower patency rate.
  
  
  METHODS
  During a 2-year period (2011-2012), we compared the vein graft patency at symptom-directed cardiac catheterization as well as wound complication rates in 210 patients who received either NT (87 patients) or endo-vein (123 patients).
  
  
  RESULTS
  The recatheterization rate for the two groups was similar: 9 (10.3%) of 87 of the NT patients versus 11 (9.0%) of 123 of the endo-vein patients. There was a significant difference in vein graft patency between the groups: 15 (94%) of 16 NT vein grafts were patent versus 6 (27%) of 22 of endo-veins (P < 0.02). The endo-vein graft patency during this 2-year period was similar to the total endo-vein patency (37%) during a 4-year period. A comparison between a more experienced and a less experienced harvester revealed no difference in patency rate. Harvest site complications were significantly higher with the NT harvest: 18% of the NT patients requiring vacuum-assisted wound closure or intravenous antibiotics versus 2% of the endo-vein patients (P < 0.0001). The application of platelet-rich plasma did not significantly lower wound complication rates (P = 0.27).
  
  
  CONCLUSIONS
  These results suggest that NT vein harvesting may be associated with improved graft patency, but methods should be developed to lower wound complication rates.
authors.affiliation: From the *Division of Cardiac Surgery, Department of Surgery, Bayhealth Medical Center, Dover, DE USA; and †Department of Thoracic and Cardiovascular Surgery, Orebro University Hospital, Orebro, Sweden.
authors.forename: John D
authors.initials: JD
authors.lastname: Mannion
authors.forename: Daniel
authors.initials: D
authors.lastname: Marelli
authors.forename: Todd
authors.initials: T
authors.lastname: Brandt
authors.forename: Megan
authors.initials: M
authors.lastname: Stallings
authors.forename: Jeffery
authors.initials: J
authors.lastname: Cirks
authors.forename: Mats
authors.initials: M
authors.lastname: Dreifaldt
authors.forename: Domingos
authors.initials: D
authors.lastname: Souza
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods*; D060053:Transplant Donor Site; D014654:Vascular Patency