Histologic evidence of the safety of endoscopic saphenous vein graft preparation Dan M Meyer, MD, Thomas E Rogers, MD, Michael E Jessen, MD, Aaron S Estrera,

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Histologic evidence of the safety of endoscopic saphenous vein graft preparation Dan M Meyer, MD, Thomas E Rogers, MD, Michael E Jessen, MD, Aaron S Estrera, MD, Albert K Chin, MD The Annals of Thoracic Surgery Volume 70, Issue 2, Pages 487-491 (August 2000) DOI: 10.1016/S0003-4975(00)01503-4

Fig 1 Tapered-tip balloon dissecting cannula (VasoView Balloon Dissection System, Guidant Corporation, Cardiac and Vascular Surgery, Menlo Park, CA). The transparent tip allows for visualization during endoscopic dissection. The Annals of Thoracic Surgery 2000 70, 487-491DOI: (10.1016/S0003-4975(00)01503-4)

Fig 2 Dissecting the tunnel during endoscopic harvesting of the saphenous vein. The tapered-tip cannula is placed on the adventitial surface of the exposed vein. The cannula is advanced under continuous visualization, initially with the balloon deflated, to form a perivascular tract. After balloon inflation and insufflation, endoscopic instruments are inserted to isolate, ligate, and transect the vein tributaries. The Annals of Thoracic Surgery 2000 70, 487-491DOI: (10.1016/S0003-4975(00)01503-4)

Fig 3 Verhoeff’s elastic stain of representative vein segments showing no abnormalities of the intimal, medial, or adventitial layers when procured using a conventional (A) or endoscopic (B) technique. The darkly stained irregular line in the upper portion of the figures (arrow) is the internal elastic lamina. The other darkly stained areas are elastic tissue in the underlying medial and adventitial layers. The insert displays an immunohistochemical stain for factor VIII:vWF showing strong staining of the endothelium, the dark line on the lumenal surface of the vein. The Annals of Thoracic Surgery 2000 70, 487-491DOI: (10.1016/S0003-4975(00)01503-4)

Fig 4 Verhoeff’s elastic stain of an endoscopically obtained vein segment showing a focal area of separation of the medial muscle fibers associated with a small amount of hemorrhage in the same area (arrow). This was noted frequently in both the endoscopic and conventionally obtained groups. The Annals of Thoracic Surgery 2000 70, 487-491DOI: (10.1016/S0003-4975(00)01503-4)