Superior long-term patency of no-touch vein graft compared to conventional vein grafts in over 1500 consecutive patients

Abstract

ObjectivesTo evaluate the long-term angiographic patency of saphenous vein grafts (SVG) harvested using the no-touch technique compared to the conventional technique.MethodsThis was a single-center, retrospective, cohort study. The inclusion criteria were individuals who underwent a CABG (coronary artery bypass grafting) between January 1995 and July 2020, and who successively needed a clinically-driven angiography. The primary endpoint was long-term patency. The secondary endpoints were differences in patency based on sub-group analysis (single vs. sequential graft, divided by target vessel).ResultsThe study included 1520 individuals (618 no-touch, 825 conventional and 77 arterial grafts). The mean clinical follow-up time was 8.4 years ± 5.5 years. The patency per patient was 70.7% in the no-touch grafts vs. 46.7% in the conventional grafts (p < 0.001, OR = 2.8). The graft patency was 75.9% in the no-touch grafts vs. 62.8% in the conventional grafts (p < 0.001, OR= 1.8).ConclusionsThe no-touch vein grafts were associated with statistically significantly higher patency at long-term compared to the conventional grafts.Clinical Trial RegistrationNCT04656366, 7 December 2020Clinical Perspective-What is new?➣The largest follow-up of the patency of no-touch vein grafts in the international literature.➣Patients with a no-touch vein graft had significantly better patency (p < 0.001) at mean follow-up of more than 8 years.-What are the clinical implications?➣Consequent reduction in cardiovascular events after no-touch vein graft.➣Benefits at individual level due to fewer episodes of re-angina and myocardial infarction, and fewer coronary interventions.➣Benefits at community level due to fewer re-hospitalizations and a reduction in healthcare costs.