The no-touch saphenous vein is an excellent alternative conduit to the radial artery 8 years after coronary artery bypass grafting: A randomized trial

J Thorac Cardiovasc Surg. 2021 Feb;161(2):624-630. doi: 10.1016/j.jtcvs.2019.09.177. Epub 2019 Oct 26.

Abstract

Background: In 2004, a prospective randomized trial demonstrated that after 3 years, saphenous veins (SVs) harvested with a no touch (NT) technique had a greater patency than radial grafts for coronary bypass surgery. Here we report the 8-year follow-up data of this trial.

Methods: The trial included 108 patients undergoing coronary artery bypass grafting (CABG). Each patient was assigned to receive 1 NT SV and 1 radial artery (RA) graft to either the left or right coronary territory to complement the left internal thoracic artery (LITA). Sequential grafting was common, so overall graft patency as well as the patency of each anastomosis were assessed.

Results: Angiography was performed in 84 patients (78%) at mean of 97 months postoperatively. Graft patency were high and similar for both NT and RA: 86% for NT versus 79% for RA (P = .22). The patency of coronary anastomoses was significantly higher with the NT SV grafts (91% vs 81%; P = .046). The NT grafts also had excellent patency in coronary arteries with <90% stenosis (93% patency) and in coronary arteries of small diameter (87% patency) or with mild calcification (88% patency). Patency for the LITA was 92%.

Conclusions: NT SV grafts have excellent patency similar to that of RA grafts after 8 years. In addition, NT SV grafts can be used in situations that are not ideal for RA grafts.

Keywords: CABG; no touch technique; patency; radial artery; saphenous vein.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Computed Tomography Angiography
  • Coronary Artery Bypass / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Radial Artery / diagnostic imaging
  • Radial Artery / transplantation*
  • Saphenous Vein / diagnostic imaging
  • Saphenous Vein / transplantation*
  • Vascular Grafting / methods
  • Vascular Patency