Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery: results of a randomized longitudinal trial.
OBJECTIVE
Conventional harvesting of the saphenous vein in coronary artery bypass surgery produces vessel damage that contributes to graft failure. A novel "no touch" technique provides high short- and long-term patency rates.


METHODS
This randomized longitudinal trial compares graft patency of two patient groups undergoing coronary artery bypass surgery. Conventional: 52 patients had their veins stripped, distended, and stored in saline solution. No-touch: 52 patients had veins removed with surrounding tissue, not distended, and stored in heparinized blood. Angiographic assessment was performed at mean time 18 months after the operation in 46 patients in the conventional group and 45 patients in the no-touch group and repeated at mean time 8.5 years in 37 patients from both groups.


RESULTS
The distribution of the grafts to the recipient coronary arteries regarding their size and quality was similar in both groups. The angiographic assessment at 18 months postoperatively showed 89% conventional versus 95% no-touch grafts were patent. Repeated angiography at 8.5 years showed a patency rate for the conventional group of 76% and 90% for the no-touch group (P = .01). The multivariate analysis showed that the most important surgical factors for graft patency were the technique of harvesting (odds ratio= 3.7, P = .007) for the no-touch versus the conventional technique and the vein quality before implantation (odds ratio = 3.2, P = .007) for veins that were of good quality. By comparison the patency of the thoracic artery grafts was 90%.


CONCLUSIONS
Harvesting the saphenous vein with surrounding tissue provides high short- and long-term patency rates comparable to the left internal thoracic artery.
Souza
Domingos S R
DS
Department of Cardiothoracic Surgery and Anesthesiology, Orebro University Hospital, SE-701 85 Orebro, Sweden. domingos.souza@orebroll.se
Johansson
Benny
B
Bojö
Leif
L
Karlsson
Roland
R
Geijer
Håkan
H
Filbey
Derek
D
Bodin
Lennart
L
Arbeus
Mikael
M
Dashwood
Michael R
MR
D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D015999:Multivariate Analysis; D012501:Saphenous Vein / Q000637:transplantation*; D013536:Suture Techniques; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency