- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02446522
Compare Endoscopic and Open Methods of Vein Harvesting for Coronary Artery Bypass Grafting
Comparative Results of Endoscopic and Open Methods of Vein Harvesting for Coronary Artery Bypass Grafting: a Prospective Randomized Parallel-group Trial.
Study Overview
Status
Intervention / Treatment
Detailed Description
The great saphenous vein (GSV) remains one of the most commonly used conduits due to its ease of harvest, availability and versatility [1] Traditional harvesting of GSV is open vein harvesting, which involves an extended leg incision. This technique is associated with a significant morbidity and wound complications occur in 2-24% of cases.
Minimally invasive techniques endoscopic vein harvesting (EVH), have therefore been developed to reduce post-CABG leg wound complications. Last time the endoscopic vein harvesting is the method of choice in many centers as it allowed reduction of post-surgical complications as compared to the open method. Although long-term graft patency following EVH has been questioned cohort studies have reported that the technique is safe and effective.
The possibility to use lymphoscintigraphy for evaluation of lower limb lymphatic system after vein harvesting for the coronary artery bypass surgeries was reported before. Nevertheless, the state of the lymphatic system after vein harvesting remains to be poorly studied.
Currently, there is no shared vision relating to integrity and quality of the conduit after the impact on the vein wall during vein harvesting. In this connection, the investigators studied the initial state of the venous conduit, interoperation damages of the vein and postoperative wound complications while using two methods of GSV harvesting.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- subjects with multivascular lesion of the coronary artery to whom coronary artery bypass surgery was indicated.
Exclusion Criteria:
- urgent coronary artery bypass surgery with unstable haemodynamics;
- previous coronary artery bypass surgery;
- chronic venous insufficiency С4-С6 under СЕAR classification;
- previous limb surgeries.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Open vein harvesting
Patients with IHD, who were underwent open vein harvest method (OVH)
|
Open vein harvesting was performed as a continuous incision under vision control.
The GSV was identified two fingers proximal to the medial malleolus according to the standard practice.
The vein was harvested using Metzenbaum scissors, and a continuous incision was made along the route of the vein.
Care was taken not to traumatize the nerve, vein or its branches.
Vein branches were ligated with titanium clips.
The wound was closed in layers with continuous 2-0 Polysorb sutures and 3-0 skin sutures.
|
Active Comparator: Endoscopic vein harvesting
Patients with IHD, who were underwent edoscopic vein harvestingopen vein harvest method (EVH).
|
Endoscopic vein harvesting was performed through minimal incisions with use of Vasoview 6 system (Maquet Medical Systems, Wayne, NJ, USA.)
The vein was identified through a 3 cm incision below the knee.
The incision site was sealed using a balloon port to create a tunnel inside the leg.
A second unit with cautery was inserted via the port to cut and seal the tributary branches.
A 1 cm skin incision was made near the groin to ligate the distal end of the GSV and remove the vein, which was checked for leakage.
The wound was closed with 3-0 skin sutures
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
postoperative wound complications
Time Frame: during 30 day after operation
|
all cases postoperative wound complications
|
during 30 day after operation
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- EVH vs OVH
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Nanjing First Hospital, Nanjing Medical UniversityCompletedCardiopulmonary Bypass | Coronary Artery Bypass GraftingChina
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Centre de Recherche de l'Institut Universitaire...Canadian Institutes of Health Research (CIHR); Boston Scientific CorporationTerminatedCoronary Artery Bypass GraftingCanada
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Cairo UniversityCompleted
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Hamilton Health Sciences CorporationCompletedCoronary Artery Bypass GraftingCanada
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Assiut UniversityCompleted
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University Medical Center GroningenCompleted
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Antalya Training and Research HospitalDr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research... and other collaboratorsCompletedMortality | Coronary Artery Bypass GraftingTurkey
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Università Vita-Salute San RaffaeleCompletedCardiac Surgery | Coronary Artery Bypass Grafting | Aortocoronary BypassCroatia, Italy, China, Malaysia, Russian Federation, Portugal, Bahrain, Brazil, Bulgaria, Czechia, Egypt, Saudi Arabia, Serbia
Clinical Trials on Open vein harvesting
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Boston Scientific CorporationHerzzentrum DresdenTerminatedCoronary Artery DiseaseGermany
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Sunnybrook Health Sciences CentreUnity Health TorontoCompletedCoronary Artery DiseaseCanada
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China National Center for Cardiovascular DiseasesUnknown
-
Seoul National University HospitalCompletedMyocardial Infarction | Stable Angina | Unstable Angina | Triple Vessel DiseaseKorea, Republic of
-
Beijing Anzhen HospitalBeijing Municipal Administration of HospitalsUnknownCoronary Artery Disease | Graft FailureChina
-
Azienda Ospedaliera San Giovanni BattistaLivaNovaUnknownCoronary Artery Bypass Grafting SurgeryItaly
-
VA Office of Research and DevelopmentCompleted
-
Sheba Medical CenterRecruitingCoronary Artery DiseaseIsrael
-
University of MilanCompletedGingival Recession | Palate; WoundItaly
-
Medical University InnsbruckRecruitingCoronary Artery DiseaseAustria, Germany, Switzerland