Acquired cardiovascular disease: Coronary
The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial

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Abstract

Objectives

This study investigates whether the no-touch (NT) vein graft, at a mean time of 16 years, maintains a significantly higher patency rate than conventional (C) vein grafts and still has patency comparable to that of the left internal thoracic artery (LITA).

Methods

A total of 156 patients accepted for coronary artery bypass grafting were randomly allocated to 1 of 3 groups. In the C group, the saphenous vein (SV) was stripped and distended. In the intermediate group, the SV was stripped but not distended. In the NT group, the SV was neither stripped nor distended, but rather harvested with a fat pedicle. This study is an angiographic follow-up of the C and NT groups, at a mean time of 16 years postoperatively.

Results

Fifty-four patients were included (C group = 27; NT group = 27). In all, 72 and 75 vein grafts were completed in groups C and NT, respectively. Crude SV graft patency was 64% in the C group versus 83% in the NT group (P = .03), which was similar to the patency of the LITA (88%). The harvesting technique had a major impact on the patency with a hazard ratio for occlusion of 1.83 for the C group (P = .04).

Conclusions

Harvesting the SV with the NT technique conferred, at a mean time of 16 years, a significantly higher patency than the conventional technique that was still comparable to that of the LITA.

Key Words

coronary artery bypass grafting
saphenous vein graft
left internal thoracic artery

Abbreviations and Acronyms

C
conventional
CABG
coronary artery bypass grafting
CI
confidence interval
HR
hazard ratio
LAD
left anterior descending
LITA
left internal thoracic artery
NT
no-touch
SV
saphenous vein

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Supported by Örebro County Council, through the regional research board and Nyckelfonden (grant #OLL-116951).

Clinical Trial Registration: NCT01686100.