Heparin versus No Heparin before Endoscopic Vein Harvesting using Angioscopy

Background: Endoscopic vein harvesting (EVH) became a standard technique with several advantages over open vein harvesting (OVH). Thrombus formation inside the vein lumen is one of the main concerns after EVH. It is not known whether heparin use before EVH could prevent this complication. The study aimed to assess the safety of not giving intravenous heparin before starting the open system EVH procedure using the PeriVu™ Disposable Angioscopy (LeMaitre® VASCULAR- France) as a modality to assess the intraluminal vein clots. Methods: This research is a randomized study that compared two groups of patients undergoing CABG. One group had 2500 IU heparin before EVH using (Virtusaph plus, Terumo) (n=50) and the other group had EVH without giving heparin (n=50). Intraluminal clots in the vein segments were evaluated using PeriVu Disposable Angioscopy ( LeMaitre-VASCULAR).  Results: Preoperative data were comparable between groups with no statistically significant difference. The mean duration of the procedure in the heparin group versus the non-heparin group was 30.6±5.8 and 28.7±5.9, respectively (P= 0.11). Intraluminal clots were detected in two segments out of 103 segments (1.94%) in the No heparin group, while none was detected in the heparin group (P= 0.24).  Conclusion: There was no difference between heparin versus no heparin during endoscopic vein harvest regarding intraluminal thrombus formation. Further studies are recommended to confirm our findings