The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endoscopic saphenous vein harvest for coronary artery bypass grafting in June 2014.
This document replaces previous guidance on endoscopic saphenous vein harvest for coronary artery bypass grafting (NICE interventional procedure guidance 343, May 2010).
Coronary artery disease (CAD) refers to hardening and narrowing of the coronary arteries as a result of atherosclerosis. This can cause angina and myocardial infarction and result in heart failure.
One of the treatment options for suitable patients is coronary artery bypass grafting. These coronary artery bypasses are usually made from the patient's own internal mammary artery or greater saphenous vein.
Traditionally, saphenous vein harvest is performed through an incision overlying the length of the saphenous vein using either a single long incision or a number of shorter incisions with skin bridges between them. Complications include wound dehiscence, infection, oedema of the leg and saphenous nerve damage leading to numbness or persistent pain in some patients. Endoscopic saphenous vein harvest aims to reduce these wound complications.
One of the following OPCS-4 codes is used to classify the coronary artery bypass grafting with a saphenous vein graft, depending on the number of arteries replaced:
K40.9 Unspecified saphenous vein graft replacement of coronary artery The endoscopic harvest of the saphenous vein is not coded in addition as this is implicit in the saphenous vein graft replacement code.