Pedicled Vein Grafts in Coronary Surgery: Perioperative Data From a Randomized Trial

Abstract

Harvesting a pedicled vein provides comparable postoperative bleeding and leg wound infection rates in selected patients. The technique is associated with a slightly longer duration of extracorporeal circulation than harvesting conventional veins. Promising early results using the pedicled vein technique may contribute to a change in standard vein harvesting technique for CABG in selected patients.

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

“…No-touch veins were harvested with an open technique – the use of skin bridges and/or drains as described by Kim and colleagues [14] may lead to a reduction in the incidence of leg wound infections. Insulin dependent diabetes was an exclusion criteria in the Norwegian study, and the body mass index was in the normal range; the incidence of wound infection was low in the NT patients and comparable with the CON [13]. We reported leg wound complications according to the intention to treat analysis as less biased – the treatment received analysis may be more relevant for leg complications.…”

Clinical Outcomes After Surgical Revascularization Using No-Touch Versus Conventional Saphenous Vein Grafts: Mid-Term Follow-Up of Propensity Score Matched Cohorts

“…In line with previous randomized controlled trials, we report longer duration of extracorporeal circulation in patients treated with NT-SVGs as compared to C-SVGs. 15,27 Notably, the cumulative repeat revascularization curves diverge during the first postoperative year after which both curves run parallel. Post-hoc analysis of the subgroups undergoing PCI procedures during follow-up, revealed significantly more postoperative myocardial infarctions in the adjusted NT-SVG cohort.…”

“…Both covariates were omitted from the propensity score model as they have been reported to be affected by the treatment of interest in previous randomized controlled trials. 14,15,27 Propensity score matching resulted in 923 pairs of C-SVG and NT-SVG patients. Baseline characteristics of the propensity matched cohorts were almost identical.…”

The evolving evidence base for coronary artery bypass grafting and arterial grafting in 2021: How to improve vein graft patency

“…Finally, Pettersen and colleagues randomized 100 patients in the IMPROVE-CABG trial to pedicled versus conventional harvesting to assess 5-year angiographic SVG function. 19 Early perioperative findings have been promising, suggesting comparable postoperative bleeding and leg wound infection rates, and long-term findings are expected in the near future.…”

“… 19 Early perioperative findings have been promising, suggesting comparable postoperative bleeding and leg wound infection rates, and long-term findings are expected in the near future.…”