What is a trade-off of endoscopic saphenous vein harvesting compared with open harvest?

• A. Increased wound infection
• B. Potentially different graft quality affecting patency
• C. Higher blood loss
• D. Longer hospital stay

Answer: (B)

Endoscopic harvesting is used to obtain the saphenous vein with smaller, less invasive incisions, which lowers leg wound complications. The trade-off to this benefit is that the process can introduce some manipulation or trauma to the vein that may affect its inner lining and overall graft quality, potentially influencing long-term patency. In other words, you gain easier healing and fewer leg wounds, but there’s a concern that the vein’s quality for grafting might be different, especially if the technique isn’t performed carefully or during a learning curve. The other options don’t fit because EVH typically reduces wound infections, lowers or does not increase blood loss, and does not inherently lengthen hospital stay compared with open harvest.