No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial

DOI Web Site 被引用文献4件
  • Meice Tian
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Xianqiang Wang
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Hansong Sun
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Wei Feng
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Yunhu Song
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Feng Lu
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Liqing Wang
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Yang Wang
    Medical Research & Biometrics Center (Yang Wang), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Bo Xu
    Department of Cardiology (B.X.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Huaibin Wang
    Beijing Hospital, China (H.W.).
  • Su Liu
    The Second Hospital of Hebei Medical University, China (S.L.).
  • Zhigang Liu
    TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China (Z.L.).
  • Yu Chen
    Peking University People’s Hospital, Beijing, China (Y.C.).
  • Qi Miao
    National Center for Cardiovascular Disease, China & Fuwai Hospital, and Peking Union Medical College Hospital (Q.M.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Pixiong Su
    Beijing Chaoyang Hospital, Capital Medical University, China (P.S.).
  • Yan Yang
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Shaoxian Guo
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Bin Lu
    Department of Radiology (B.L.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Zhiqiang Sun
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Kaiyang Liu
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Changwei Zhang
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Yue Wu
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Haitao Xu
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Wei Zhao
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Chao Han
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Xingtong Zhou
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Enshi Wang
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Xiaoning Huo
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Shengshou Hu
    Department of Surgery (M.T., X.W., H.S., W.F., Y.S., F.L., L.W., Y.Y., S.G., Z.S., K.L., C.Z., Yue Wu, H.X., W.Z., C.H., X.Z., E.W., X.H., S.H.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

抄録

<jats:sec> <jats:title>Background:</jats:title> <jats:p>Vein graft occlusion is deemed a major challenge in coronary artery bypass grafting. Previous studies implied that the no-touch technique for vein graft harvesting could reduce occlusion rate compared with the conventional approach; however, evidence on the clinical benefit and generalizability of the no-touch technique is scare.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>From April 2017 to June 2019, we randomly assigned 2655 patients undergoing coronary artery bypass grafting at 7 hospitals in a 1:1 ratio to receive no-touch technique or conventional approach for vein harvesting. The primary outcome was vein graft occlusion on computed tomography angiography at 3 months and the secondary outcomes included 12-month vein graft occlusion, recurrence of angina, and major adverse cardiac and cerebrovascular events. The generalized estimate equation model was used to account for the cluster effect of grafts from the same patient.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> During the follow-up, 2533 (96.0%) participants received computed tomography angiography at 3 months after coronary artery bypass grafting and 2434 (92.2%) received it at 12 months. The no-touch group had significantly lower rates of vein graft occlusion than the conventional group both at 3 months (2.8% versus 4.8%; odds ratio, 0.57 [95% CI, 0.41–0.80]; <jats:italic>P</jats:italic> <0.001) and 12 months (3.7% versus 6.5%; odds ratio, 0.56 [95% CI, 0.41–0.76]; <jats:italic>P</jats:italic> <0.001). Recurrence of angina was also less common in the no-touch group at 12 months (2.3% versus 4.1%; odds ratio, 0.55 [95% CI, 0.35–0.85]; <jats:italic>P</jats:italic> <0.01). Rates of major adverse cardiac and cerebrovascular events were of no significant difference between the 2 groups. The no-touch technique was associated with higher rates of leg wound surgical interventions at 3-month follow-up (10.3% versus 4.3%; odds ratio, 2.55 [95% CI, 1.85–3.52]; <jats:italic>P</jats:italic> <0.001). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Compared with the conventional vein harvesting approach in coronary artery bypass grafting, the no-touch technique significantly reduced the risk of vein graft occlusion and improved patient prognosis.</jats:p> </jats:sec> <jats:sec> <jats:title>Registration:</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov">https://www.clinicaltrials.gov</jats:ext-link> ; Unique identifier: NCT03126409. </jats:p> </jats:sec>

収録刊行物

  • Circulation

    Circulation 144 (14), 1120-1129, 2021-10-05

    Ovid Technologies (Wolters Kluwer Health)

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