Ninos Samano1, Håkan Geijer2, Mats Liden2, Stephen Fremes3, Lennart Bodin4, Domingos Souza5. 1. Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 2. Department of Radiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 3. Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 4. Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. 5. Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. Electronic address: domingos.ramosdesouza@regionorebrolan.se.
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.
RCT Entities:
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.
Authors: Walid Ben Ali; Pierre Voisine; Peter Skov Olsen; Hugues Jeanmart; Nicolas Noiseux; Tracy Goeken; Vilas Satishchandran; Filippo Cademartiri; Garry Cutter; Dave Veerasingam; Craig Brown; Maximilian Y Emmert; Louis P Perrault Journal: Open Heart Date: 2018-04-13
Authors: Margreet R de Vries; Karin H Simons; J Wouter Jukema; Jerry Braun; Paul H A Quax Journal: Nat Rev Cardiol Date: 2016-05-19 Impact factor: 32.419