SUPERIOR SVG: no touch saphenous harvesting to improve patency following coronary bypass grafting (a multi-Centre randomized control trial, NCT01047449)

• BackgroundSingle centre studies support No Touch (NT) saphenous vein graft (SVG) harvesting technique. The primary objective of the SUPERIOR SVG study was to determine whether NT versus conventional (CON) SVG harvesting was associated with improved SVG patency 1year after coronary artery bypass grafting surgery (CABG).MethodsAdults undergoing isolated CABG with at least 1 SVG were eligible. CT angiography was performed 1-year post CABG. Leg adverse events were assessed with a questionnaire. A systematic review was performed for published NT graft patency studies and results aggregated including the SUPERIOR study results.ResultsTwo hundred and-fifty patients were randomized across 12-centres (NT 127 versus CON 123 patients). The primary outcome (study SVG occlusion or cardiovascular (CV) death) was not significantly different in NT versus CON (NT: 7/127 (5.5%), CON 13/123 (10.6%), p=0.15). Similarly, the proportion of study SVGs with significant stenosis or total occlusion was not significantly different between groups (NT: 8/102 (7.8%), CON: 16/107 (15.0%), p=0.11). Vein harvest site infection was more common in the NT patients 1month postoperatively (23.3% vs 9.5%, p<0.01). Including this study's results, in a meta-analysis, NT was associated with a significant reduction in SVG occlusion, Odds Ratio 0.49, 95% Confidence Interval 0.29-0.82, p=0.007 in 3 randomized and 1 observational study at 1year postoperatively.ConclusionsThe NT technique was not associated with improved patency of SVGs at 1-year following CABG while early vein harvest infection was increased. The aggregated data is supportive of an important reduction of SVG occlusion at 1year with NT harvesting.Trial registrationNCT01047449.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

No touch atraumatic saphenous vein graft harvesting

Conventional open

saphenous vein graft harvesting

Endoscopic saphenous vein graft

harvesting

Multi-centred randomized controlled trial

Coronary artery

bypass grafting surgery

Graft patency

Major adverse cardiac and

cerebrovascular outcomes

internal-thoracic-artery

pedicled vein grafts

surrounding tissue

surgery

atherosclerosis

progression

Conventional open saphenous vein graft harvesting

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