1. No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial
- Author
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Qi Miao, Feng Lü, Meice Tian, Liqing Wang, Kaiyang Liu, Wei Zhao, Yang Wang, Xingtong Zhou, Pixiong Su, Su Liu, Xianqiang Wang, Chao Han, Changwei Zhang, Yunhu Song, Yan Yang, Shaoxian Guo, Bin Lu, Enshi Wang, Shengshou Hu, Yu Chen, Wu Yue, Hansong Sun, Bo Xu, Huaibin Wang, Xiaoning Huo, Zhigang Liu, Zhiqiang Sun, Haitao Xu, and Wei Feng
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Bypass grafting ,business.industry ,Vein graft ,Middle Aged ,law.invention ,Surgery ,Vein harvesting ,Treatment Outcome ,medicine.anatomical_structure ,Randomized controlled trial ,law ,Physiology (medical) ,Occlusion ,medicine ,Humans ,Female ,Coronary Artery Bypass ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Artery - Abstract
Background: Vein graft occlusion is deemed a major challenge in coronary artery bypass grafting. Previous studies implied that the no-touch technique for vein graft harvesting could reduce occlusion rate compared with the conventional approach; however, evidence on the clinical benefit and generalizability of the no-touch technique is scare. Methods: From April 2017 to June 2019, we randomly assigned 2655 patients undergoing coronary artery bypass grafting at 7 hospitals in a 1:1 ratio to receive no-touch technique or conventional approach for vein harvesting. The primary outcome was vein graft occlusion on computed tomography angiography at 3 months and the secondary outcomes included 12-month vein graft occlusion, recurrence of angina, and major adverse cardiac and cerebrovascular events. The generalized estimate equation model was used to account for the cluster effect of grafts from the same patient. Results: During the follow-up, 2533 (96.0%) participants received computed tomography angiography at 3 months after coronary artery bypass grafting and 2434 (92.2%) received it at 12 months. The no-touch group had significantly lower rates of vein graft occlusion than the conventional group both at 3 months (2.8% versus 4.8%; odds ratio, 0.57 [95% CI, 0.41–0.80]; P P P P Conclusions: Compared with the conventional vein harvesting approach in coronary artery bypass grafting, the no-touch technique significantly reduced the risk of vein graft occlusion and improved patient prognosis. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03126409.
- Published
- 2021