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

Abstract

Background Single 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 1 year after coronary artery bypass grafting surgery (CABG). Methods Adults 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. Results Two 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 1 month 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 1 year postoperatively. Conclusions The 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 1 year with NT harvesting. Trial registration NCT01047449 . Electronic supplementary material The online version of this article (10.1186/s13019-019-0887-x) contains supplementary material, which is available to authorized users.

Perioperative routines and surgical techniques for saphenous vein harvesting in CABG surgery: a national cross-sectional study in Sweden

“…This might be the main reason why, in this study, the open vein harvesting technique was used by 100% of respondents. The NT has gradually increased in popularity [27], possibly because graft patency with this technique have been demonstrated to be superior to those with CT [17,28]. Nevertheless, CT was used by 78.6% of the participants in the present study.…”

Stable Hemodynamics within “No-Touch” Saphenous Vein Graft

“…In our experience, if there was too much slack in the thread, the suture must be pulled tight to take up the slack as early as possible. We did not confront with serious incision complication 24) except for the appearance such as subcutaneous ecchymosis and swelling.…”

The clinical application of microincision vein harvesting of the great saphenous vein in coronary artery bypass grafting

“…MVH of the GSV has the advantages of being a treatment that only involves a small trauma region, so ensures a fast recovery, a short duration procedure, well-performed incisions, and a low operation cost [6]. MVH of the GSV is considered similar to no-touch technology [7,8]; therefore, it is gradually being adopted in many hospitals in China. MVH is additionally becoming the preferred method as a result of the simple equipment used in MVH technology, mainly including head-mounted lights, venous hooks, and titanium metal clips.…”