Purpose: Injury incurred during saphenous vein harvesting results in poor graft patency and impairs the results of coronary artery bypass grafting surgery. A novel harvest method, the No-touch technique, has shown improved long-term saphenous vein graft patency. The purpose of this trial was to compare the patency rate between the No-touch saphenous vein and radial artery grafts.
Methods: This randomized trial included 108 patients undergoing coronary artery bypass grafting and compared the patency for No-touch saphenous vein with radial artery grafts. Each patient was assigned to receive one No-touch saphenous vein and one radial artery graft either to the left or right coronary territory to complement the left internal thoracic artery.
Results: Angiography was performed in 99 patients (92%) at mean 36 months postoperatively. Graft and grafted coronary artery patency was evaluated. Patent grafts for No-touch saphenous vein and radial artery was 93/99 (94%) versus 81/99 (82%), (p=0.01), respectively. Patent coronary arteries grafted with No-touch saphenous vein and radial artery grafts was 149/157 (95%) versus 123/146 (84%), (p=0.005), respectively. Eighty-nine of 96 (93%) left internal thoracic artery grafts were patent.
Conclusions: No-touch saphenous vein grafts showed a significantly higher patency rate than the radial artery grafts and were comparable to the patency for left internal thoracic artery grafts. This highlights the improvement in saphenous vein graft quality with No-touch technique and increases the number of situations where saphenous veins may be preferable to radial artery grafts as conduits in coronary artery bypass grafting.
Source: STS.
