SWEDEGRAFT: 'No-Touch' vs. Conventional Vein Harvesting For CABG
Findings from the SWEDEGRAFT trial presented at ESC Congress 2024 in London showed no benefits to using a "no-touch" technique to harvest the saphenous vein graft during CABG compared with the conventional technique that involves stripping the vein of surrounding tissue prior to grafting.
Researchers randomized 902 patients under the age of 80 years who were scheduled for first-time isolated nonemergent CABG with at least one saphenous vein graph to either the no-touch technique or the conventional technique.
Overall results showed no significant difference in the primary endpoint of graft failure within two years, which occurred in 19.8% of patients in the no-touch cohort and 24% of patients in the conventional cohort. In terms of the secondary endpoints, the incidence of major adverse cardiovascular events was similar between the two groups (12.6% vs. 9.9%, respectively). Researchers did note that patients in the `no-touch group had significantly more post-operative leg wound complications (24.7%) compared with those in the conventional group (13.8%).
"We have shown that the no-touch technique was not superior to the conventional technique in reducing graft failure or improving clinical events after CABG," said Study Chair Stefan James, MD, PhD. "Our study highlights the importance of independent research where dedicated clinicians collaborate in large all-comer randomized controlled trials to determine the best treatment for the benefit of our patients. Results from this pragmatic registry trial do not support the routine use of no-touch harvesting and our findings should be considered in future guidelines."
Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention
Keywords: ESC Congress, ESC24, Coronary Artery Bypass, Tissue and Organ Harvesting