Skip to main content

Research Repository

Advanced Search

Endoscopic vein harvesting - Research Support Funding

People Involved

Profile image of Mr John Turgoose

Mr John Turgoose J.Turgoose@hull.ac.uk
Information Systems Manager - Hull Health Trials Unit

Project Description

The long saphenous vein remains the most frequently used conduit for coronary artery bypass grafting. Traditionally, the harvesting of this conduit has been by open incision extending upwards from the ankle in the inner side of the leg up to the groin, depending on the number of bypass grafts required. The significant morbidity that can be associated with this method of saphenous vein harvest has led to a general move towards endoscopic vein harvesting which is a minimally invasive approach. The initial concern and claims that EVH could compromise the quality, integrity, and consequently the patency of the saphenous grafts has been convincingly refuted in a large US study (Zenati et al, NEJM 2019;380:132-141). However, this identified the need for suitably qualified surgeons to perform the technique to ensure safety, and did not assess cost-effectiveness.

EVH is still not the standard of care in Hull and at many of UK centres? The level of equipoise of cardiothoracic surgeons, and the main barriers to adoption have not been explored. The additional cost of the procedure is one reason it has not been widely adopted, with patient kits costing approx. £500. However, as the procedure is less invasive, patient recovery, inpatient time and healthcare costs around wound management could be lower and there could be a positive impact on QoL after CABG. There is a need for a fully-powered, pragmatic, cost-effectiveness trial of EVH versus open vein harvesting (OVH) to provide evidence of safety, clinical effectiveness and cost effectiveness. The NIHR HTA programme would be the most suitable funding stream for this application, and the aim of this Research Support Funding application is to conduct the preliminary work required to inform a quality NIHR application and build collaboration between the clinical team and research methodologists.

Status Project Complete
Funder(s) Hull University Teaching Hospitals NHS Trust
Value £10,631.00
Project Dates Aug 1, 2022 - Jul 31, 2023

You might also like

LIPS: A prospective registry-based cohort study to monitor the diagnosis and management of acute leukaemia in pregnancy Jun 1, 2018 - Feb 28, 2022
Acute leukaemia (AL) is an aggressive but potentially curable cancer that can affect women of childbearing age. When a pregnancy is complicated by a diagnosis of AL, clinicians face a complex dilemma: to balance risking the mother’s survival through... Read More about LIPS: A prospective registry-based cohort study to monitor the diagnosis and management of acute leukaemia in pregnancy.

PUMA: Paediatric early warning system (PEWS): Utilisation and Mortality Avoidance. A prospective, mixed methods, before and after study identifying the evidence base for the core components of an effective PEWS and the development of an implementation package for implementation and use in the UK Oct 1, 2017 - Oct 31, 2018
In 2011 a research study compared the child health outcomes and death rate in the UK with other European countries. It was worrying that UK measures of child health were amongst the worst in Europe. It is not clear why that is and further work needs... Read More about PUMA: Paediatric early warning system (PEWS): Utilisation and Mortality Avoidance. A prospective, mixed methods, before and after study identifying the evidence base for the core components of an effective PEWS and the development of an implementation package for implementation and use in the UK.

BRAVO: High grade bladder cancer: a randomised controlled trial of radical cystectomy against intra-vesical immunotherapy – a feasibility study Oct 1, 2017 - Sep 30, 2018
Bladder cancer is a common disease with worse outcomes in Yorkshire than in the rest of the UK. We want to conduct a randomized trial to evaluate the best treatment for aggressive bladder cancer when found at an early stage. This could be complete b... Read More about BRAVO: High grade bladder cancer: a randomised controlled trial of radical cystectomy against intra-vesical immunotherapy – a feasibility study.