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Long-term results of percutaneous coronary intervention in no-touch vein grafts are significantly better than in conventional vein grafts
Örebro University, School of Medical Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Cardiology and Cardiothoracic Surgery, Blekinge Hospital, Karlskrona, Sweden.ORCID iD: 0000-0001-8786-2188
Örebro University, School of Medical Sciences. Department of Radiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0003-3253-8967
Örebro University, School of Medical Sciences. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-3552-9153
School of Health and Welfare, Halmstad University, Halmstad, Sweden.
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2024 (English)In: Perfusion, ISSN 0267-6591, E-ISSN 1477-111X, article id 2676591241230012Article in journal (Refereed) Epub ahead of print
Abstract [en]

INTRODUCTION: Conventional vein grafts have a high risk of thrombosis and early atherosclerosis. Percutaneous coronary intervention (PCI) in conventional vein grafts is associated with a higher incidence of late adverse cardiac events. The aim of this study was to evaluate the long-term results after PCI in saphenous vein grafts (SVG) harvested with the no-touch technique compared to the conventional technique.

METHODS: This was a single-center, retrospective, cohort study, based on data from the Swedeheart register. The inclusion criterion was individuals who underwent CABG using different vein graft techniques between January 1992 and July 2020, and who required a PCI in SVGs between January 2006 and July 2020. The primary end point was long-term in-stent restenosis. The secondary endpoints were long-term major adverse cardiac events (MACE) and 1-year re-hospitalization rates. The associations between the graft types and the endpoints were evaluated using the Fine and Gray competing-risk regression analysis.

RESULTS: The study included 346 individuals (67 no-touch, 279 conventional). The mean clinical follow-up time was 6.4 years with a standard deviation of 3.7 years. The long-term in-stent restenosis rate for the no-touch grafts was 3.2% compared to 18.7% for the conventional grafts (p < .01), with a subdistribution hazard ratio (SHR) of 0.16 (p = .010). The long-term MACE rate was 27.0% in the no-touch group and 48.3% in the conventional group (p < .01) with a SHR of 0.53 (p = .017). The short-term results were similar in both groups.

CONCLUSIONS: Percutaneous coronary intervention in a no-touch vein graft was associated with statistically significantly fewer in-stent restenoses and MACE at long-term follow-up compared to a conventional SVG.

Place, publisher, year, edition, pages
Sage Publications, 2024. article id 2676591241230012
Keywords [en]
coronary artery bypass graft, major adverse cardiac events, no-touch, percutaneous coronary intervention, saphenous vein, stent
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-111036DOI: 10.1177/02676591241230012ISI: 001147222400001PubMedID: 38253348Scopus ID: 2-s2.0-85182996475OAI: oai:DiVA.org:oru-111036DiVA, id: diva2:1832817
Funder
Region Örebro County, OLL-935188Region Uppsala, RFR-55691Available from: 2024-01-30 Created: 2024-01-30 Last updated: 2024-02-05Bibliographically approved

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Ferrari, GabrieleGeijer, HåkanCao, YangSamano, Ninos

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