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SUPERIOR SVG: no touch saphenous harvesting to improve patency following coronary bypass grafting (a multi-Centre randomized control trial, NCT01047449)
Sunnybrook Health Sciences Centre, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Cardiothoracic and Vascular Surgery.
Department of Surgery, Western University, London Health Sciences Centre, London, Canada.
Vise andre og tillknytning
2019 (engelsk)Inngår i: Journal of Cardiothoracic Surgery, ISSN 1749-8090, E-ISSN 1749-8090, Vol. 14, nr 1, artikkel-id 85Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

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 .

sted, utgiver, år, opplag, sider
BioMed Central, 2019. Vol. 14, nr 1, artikkel-id 85
Emneord [en]
Conventional open saphenous vein graft harvesting, Coronary artery bypass grafting surgery, Endoscopic saphenous vein graft harvesting, Graft patency, Major adverse cardiac and cerebrovascular outcomes, Multi-centred randomized controlled trial, No touch atraumatic saphenous vein graft harvesting
HSV kategori
Identifikatorer
URN: urn:nbn:se:oru:diva-74197DOI: 10.1186/s13019-019-0887-xISI: 000466891000002PubMedID: 31046806Scopus ID: 2-s2.0-85065231407OAI: oai:DiVA.org:oru-74197DiVA, id: diva2:1315620
Merknad

Funding Agencies:

Heart and Stroke Foundation of Canada  7092 

Canadian Institutes of Health Research  

Centre for Trials Internationally (CANNeCTIN) 

Tilgjengelig fra: 2019-05-14 Laget: 2019-05-14 Sist oppdatert: 2019-06-19bibliografisk kontrollert

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