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"The Quest for Quality""The Quest for Quality""The Quest for Quality"

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EXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and support

EXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and supportEXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and supportEXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and support

FROM YOUR FIRST CASE TO YOUR LAST

EXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and support

EXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and supportEXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and supportEXTREME "No Touch" EVH (Endoscopic Vessel Harvesting) training and support

FROM YOUR FIRST CASE TO YOUR LAST

Free online live EVH training

"Keys To Success" Course

Entry level for harvesters just starting EVH, to approximately 200 cases.  Very extensive training of technique, ultrasound, tower mechanics and instrument design.  Courses are four hours online performed weekly.


"Quest for Quality" Course

Very advanced training for the established harvester.  

Find out more

Online Live EVH Training Courses

We are a team

Surgical Products to help your evh

Please click below for more information.  

Part #: 331-000-400

Find out more

Continually expanding video library

Full cases and video clips of various parts of the procedure, tips and techniques

http://vimeo.com/user/109951183/folder/1547805

http://vimeo.com/user/109951183/folder/11650945

Check it out
Hello

Paula's Page

Witness the course results.  Paula, a recent new grad and new harvester performing at an extreme level.  Totally awesome.....

Find out more

For more free online course information

Contact your local representative or Drop us a line!

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Registration for online courses through your local EVH representative

"The Quest for Quality"

Free Online Ultrasound Training comimg soon

Correct Vein Confirmation

Never get fooled again

Determine flow abnormalities

Fully evaluating the "coronary" you are harvesting

Using calipers to measure vein size

Calipers to match the vein to the target vessel

Small details make a huge difference

Learn not to be mistaken

Learn about the saphenous vein as a organ(advanced course).

Acknowledgments to

Domingos Ramos de Souza MD PHD, Örebro University Hospital.

Michael Dashwood PHD, University College London

Perivascular Adipose Tissue

  • Biochemical component

Adipocyte-derived relaxing factors

NO, NOS, Leptin, Adiponectin

 Prostaglandin, Adenosine, Stem Cells


  • Adrenergic nerves

                 Densely innervated mainly by unmyelinated sympathetic        nerves along with several layers of smooth muscle cells


  • Vasa Vasorum

Vessels of the VV actively regulate their own tone

 Vital for cellular survival

          

  • Tunica Adventitia offers functional support 

The strong outer covering of arteries and veins.  It is composed of connective tissue as well as interlocking collagen and elastic fibers allowing stretch but preventing over-expansion when the vein is exposed to arterial pressure maintaining luminal flow.

Vasa Vasorum

On the surface of the adventitia, feeding arteries branched into longitudinally oriented stems termed second order arteries (A2). These arteries then branched into perpendicularly oriented short stems of precapillary arterioles (A3), continuing into the deeper-located 3D capillary network 

If preserved during harvest, these fill retrograde maintaining cellular survival and reducing ischemia and inflammatory response.

Vasa Vasorum

Vasa Vasorum

If preserved, will fill retrograde after transplantation helping increase post implant patency

Removal of the PVAT or Perivascular Adipose Tissue has detrimental effects on the Tunica Media and Tunica Intima

The organ blood supply

We must preserve  

Videos, check out the video clips page for more

Recent routine case

Extreme "No Touch" 3/2023

Heavy PVAT

Recent "Popcorn Fat" Type case

What used to be difficult....just another fun day in Vasoview Land

Extreme "No Touch" EVH case 6/30/22

Can't really get more "No Touch" than this....But will keep trying!

"No Touch , Whole Leg June 22 HP2

Perfect Results Every Time...For Sure!!

Just following a simple few rules from the courses

"No Touch case May, 2022 HP2

Check it out, high level quality and fun

Everything is possible

Of course there are different levels of "No Touch"

Close the deal

Just another day of providing the best surgical procedure

Whole leg harvest

So much easier with some advanced tricks

Scientific Papers

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.121.055525

https://europepmc.org/article/PMC/PMC5407140#r12

https://academic.oup.com/bjs/article/88/9/

1209/6267724?login=false

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731844/

https://anatomypubs.onlinelibrary.wiley.com/doi/full/10.1002/ar.a.20098

https://europepmc.org/article/MED/17264517

https://scholar.google.com/scholar_lookup?journal=J+Thorac+Cardiovasc+Surg&title=Harvesting+the+saphenous+vein+with+surrounding+tissue+for+CABGprovides+long-term+graft+patency+comparable+to+the+left+internal+thoracicartery:+results+of+a+randomized+longitudinal+trial&author=DS+Souza&author=B+Johansson&author=L+Bojo&author=R+Karlsson&author=H+Geijer&volume=132&issue=2&publication_year=2006&pages=373-378&pmid=16872965&

http://www.jtcvs.org/article/S0022522315012386/pdf

https://europepmc.org/article/PMC/PMC5407140#free-full-text

http://europepmc.org/article/MED/15258684

https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0777-x

https://www.ahajournals.org/doi/10.1161/circulationaha.111.039842

file:///Users/jpkeuler/INTERVASC-new/Clinical/Papers%20to%20send/Keuler%20research%201/Pathogenesis%20of%20Atherosclerosis.webarchive

https://www.annalsthoracicsurgery.org/article/S0003-4975(05)00400-5/fulltext

https://www.sciencedirect.com/science/article/abs/pii/S0022522319323578

https://www.sciencedirect.com/science/article/pii/S0022522315012386

https://www.sciencedirect.com/science/article/abs/pii/S0003497513005985

https://www.annalsthoracicsurgery.org/article/0003-4975(96)00538-3/pdf

Similar articles for PMID: 31985987 - Search Results - PubMed

Saphenous vein graft longevity: open or endoscopic, with VEST or without?

Endoscopic Vein Harvesting - StatPearls - NCBI Bookshelf

Endoscopic greater saphenous vein harvesting reduces the morbidity of coronary artery bypass surgery - PubMed

[Endoscopic harvest of great saphenous vein for infrainguinal arterial bypass: summary of our initial experience] - PubMed

Endoscopic vein harvesting: technique, outcomes, concerns & controversies - PubMed

Experienced operators achieve superior patency and wound complication rates with endoscopic great saphenous vein harvest compared with open harvest in lower extremity bypasses - PubMed

Is endoscopic harvesting bad for saphenous vein graft patency in coronary surgery? - PubMed

No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial

Endoscopic or No-Touch Vein Harvesting for CABG: What is Best for the Patient? - Abstract - Europe PMC

Preserved endothelial integrity and nitric oxide synthase in saphenous vein grafts harvested by a ‘no-touch’ technique | British Journal of Surgery | Oxford Academic

Saphenous Vein Vasa Vasorum as a Potential Target for Perivascular Fat-Derived Factors - PMC

Three‐dimensional arrangement of the vasa vasorum in explanted segments of the aged human great saphenous vein: Scanning electron microscopy and three‐dimensional morphometry of vascular corrosion casts - Lametschwandtner - 2004 - The Anatomical Record Part A: Discoveries in Molecular, Cellular, and Evolutionary Biology - Wiley Online Library

Architectonic arrangement of the vasa vasorum of the human great saphenous vein. - Abstract - Europe PMC

https-//pubmed.ncbi...ov/38637419/





Files coming soon.

Video clips, many more on videos page in menu selection top

"Tip Find Exposed"

The new "TIP SEARCH"

"Tip Find Exposed"

How could we not  figure this out earlier??

"Tip Find Exposed and confirmed"

New tricks continually 

ERAH Videos

"No Touch" Radial Harvest

Comprehensive ERAH with tourniquet

No Tourniquet ERAH

ERAH performed without a tourniquet

Who is intervasc llc

Our Expertise

Our Experience

Our Experience

Founder and President

INTERVASC, LLC: International Vascular Consultants   October 1997 – Present 

 -Provide training and support for endoscopic vein and radial artery harvesting locally, nationally and internationally. 

-Consultant for businesses and practices to expand minimally invasive surgical programs and maintain staff stability. 

-Integral in the early development and design of EVH products and developed the standard technique used for the Vasoview harvesting system.

-Developed the ‘GENTTL’ Technique for vessel harvesting, 2009.  A new technique of harvesting emphasizing exceptional conduit quality, quickly becoming the standard technique in the world

-Developed an international training program including 25 Canadian trips, 12 European trips involving six countries, 13 Asian trips involving six countries and 1 South American trip establishing EVH programs and maintaining contacts in all continents.

-Presented and performed live cases at numerous major national and international meetings on Minimally Invasive Surgery

-Performed the first endoscopic radial artery harvesting in the United States, Europe and Asia utilizing the Vasoview vessel harvesting system and subsequently developed the surgical protocol for this procedure.

-Developed a training center for EVH in Milwaukee, WI establishing a world renowned center of excellence for endoscopic vessel surgery.

-Assisted in designing and performing the Vasoview endoscopic transthoracic sympathectomy program in Milwaukee,WI.

-Helped develop the PA surgical assistance profession in Seoul, South Korea.

-Provided sales marketing and clinical training to various international distributors.

-Integrated sales and marketing with surgical training resulting in significant surgical growth for EVH in multiple international centers.

-Developed Industry Training programs for educating field representatives for numerous medical industry corporations.

Currently providing online EVH Training for the US, Europe, Middle East, South Africa, South America, Canada and Australia.


Founder and President

INTERVASC Productions  January 2003 – Present .

Video production of endoscopic procedures used in marketing and training in US and international medical centers.


Co-founder and Partner

ENDOVATIONS, LLP March 2005 -2012


Co-developed a MD/PA team approach for training multiple endoscopic cardiovascular surgical procedures to increase practice marketability.


Founder and Partner, Director of Marketing

Hearthside Care, LLP   1999 – 2003

Community Based Residential Facility (CBRF) group home for the elderly providing residence and care in a home-like setting. State of Wisconsin licensed.


Founder and Director

Wisconsin Cardiovascular Tissue Procurement Agency   1989 – 1994 Harvesting human heart valves and saphenous veins for cryopreservationin the state of Wisconsin, supplying implants throughout the world. 

Our Experience

Our Experience

Our Experience

A multidiscipline, highly skilled medical clinician with broad experience providing quality focused care for comprehensive and complex cardiac surgery. Involved in an aggressive and busy Cardiovascular Surgical practice in Milwaukee, WI.  Diverse background in developing and incorporating new technologies in medical practices throughout the world, performing both sales and clinical specialist support. Created a widely-adopted teaching program focusing on quality conduits that facilitates reduction in learning curves and improved outcomes for participants and their patients. Extensive expertise in high quality harvesting and training for Endoscopic Vein Harvesting (EVH).

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      Our staff

      Founder: James P. Keuler PA-C

      Paula Zdanowski PA-C: Directer of Social Media

      paulazdanowski@evhquality.com 

      Medical Staff


      "The Quest for Quality"

      jpkeuler@gmail.com

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