No-touch versus conventional saphenous vein harvesting technique in coronary artery bypass grafting: A systematic review and meta-analysis

Abstract

Background

The saphenous vein graft (SVG) remains widely used in coronary artery bypass grafting (CABG). The no-touch (NT) technique offers atraumatic procedures in vein harvesting. Its effectiveness is still compared to conventional (CON) methods.

Method

We conducted a systematic review using electronic databases, focusing on studies that compared the NT and CON techniques in CABG. The primary outcomes assessed were major adverse cardiac and cerebrovascular events (MACCE), graft patency, and leg complications. Kaplan–Meier estimates and the Cox proportional hazards model were used to analyze MACCE-free survival. This study has been registered on PROSPERO(CRD42024553619).

Results

A total of seven studies, including three randomized controlled trials and four prospective cohort studies, encompassing 3859 patients, were included in the analysis. The NT technique showed significantly higher overall graft patency (OR 1.59; 95% CI 1.18–2.15; p < 0.001; I²= 49%), especially in the right coronary artery (OR 1.63; 95% CI 1.25–2.13; p < 0.001; I²= 0%). However, the NT technique had a higher incidence of leg complications (OR 2.49; 95% CI 1.73–3.60; p < 0.001; I²= 10%). No significant difference in 3-year MACCE-free survival (log-rank p = 0.47).

Conclusion

The NT SVG harvesting technique has the potential to improve patency rates, especially when utilized as a conduit to the right coronary artery territory.

Keywords

Coronary artery bypass grafting saphenous vein graft no-touch technique conventional technique graft patency leg complications

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