Progress of Effect of No-touch Technique on Patency Rate of Vein Grafts after Coronary Artery Bypass Grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 ZHANGYan , SUNHan-song , HUSheng-shou

Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P. R. China;

Corresponding?author：

ZHANGYan, Email: waikezhangyan@126.com

Keywords：

No-touch technique; Coronary artery bypass grafting; Vein graft; Patency rate

DOI：

10.7507/1007-4848.20160197

Video：

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Coronary artery bypass grafting (CABG) is an effective method for the treatment of coronary heart disease at present. However, there is still a high rate of vein graft occlusion after CABG, which has a serious impact on the short and long-term clinical results. Venous access technique has been considered as an important factor on affecting the long-term patency rate. Compared with harvesting technology of the open saphenous vein harvesting, no-touch technology retained the surrounding tissue and vascular adventitia of great saphenous vein, and it avoided the high pressure of expansion vein. After CABG was performed by using the no-touch technique, the vein grafts obtained a better short and long-term patency rate, but the effect still needs further clinical verification.

Citation： ZHANGYan, SUNHan-song, HUSheng-shou. Progress of Effect of No-touch Technique on Patency Rate of Vein Grafts after Coronary Artery Bypass Grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 827-831. doi: 10.7507/1007-4848.20160197 Copy

1.	Farkouh ME, Domanski M, Sleeper LA, et al. Strategies for multive-ssel revascularization in patients with diabetes. N Engl J Med, 2012, 367(25):2375-2384.
2.	Mohr FW, Morice MC, Kappetein AP, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease:5-year follow-up of the randomised, clinical SYNTAX trial. Lancet, 2013, 381(9867):629-638.
3.	胡盛壽, 鄭哲, 周玉燕.常規與非體外循環冠狀動脈旁路移植術治療冠狀動脈多支病變的對比分析.中國胸心血管外科臨床雜志, 2000, 7(4):221-224.
4.	Fitzgibbon GM, Kafka HP, Leach AJ, et al. Coronary bypass graft fate and patient outcome:angiographic follow-up of 5, 065 grafts related to survival and reoperation in 1, 388 patients during 25 years. J Am Coll Cardiol, 1996, 28(3):616-626.
5.	Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphe-nous vein and left internal mammary artery grafts after coronary artery bypass surgery:results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol, 2004, 44(11):2149-2156.
6.	Manninen HI, Jaakkola P, Suhonen M, et al. Angiographic predic-tors of graft patency and disease progression after coronary artery bypass grafting with arterial and venous grafts. Ann Thorac Surg, 1998, 66(4):1289-1294.
7.	Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphe-nous vein and left internal mammary artery grafts after coronary artery bypass surgery:results from a department of veterans affairs cooperative study. J Am Coll Cardiol, 2004, 44(11):2149-2156.
8.	Parang P, Arora R. Coronary vein graft disease:pathogenesis and prevention. Can J Cardiol, 2009, 25(2):e57-e62.
9.	Verma S, Lovren F, Pan Y, et al. Pedicled no-touch saphenous vein graft harvest limits vascular smooth muscle cell activation:the PATENT saphenous vein graft study. Eur J Cardiothorac Surg, 2014, 45(4):717-725.
10.	Samano N, Geijer H, Liden M, et al. The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery:A randomized trial. J Thorac Cardiovasc Surg, 2015, 150(4):880-888.
11.	Favaloro RG. Saphenous vein graft in the surgical treatment of coronary artery disease. Operative technique. J Thorac Cardiovasc Surg, 1969, 58(2):178-185.
12.	Oddershede L, Andreasen JJ, Brocki BC, et al. Economic evaluation of endoscopic versus open vein harvest for coronary artery bypass grafting. Ann Thorac Surg, 2012, 93(4):1174-1180.
13.	Andreasen JJ, Nekrasas V, Dethlefsen C. Endoscopic vs open saphe-nous vein harvest for coronary artery bypass grafting:a prospective randomized trial. Eur J Cardiothorac Surg, 2008, 34(2):384-389.
14.	Lumsden AB, Eaves FR, Ofenloch JC, et al. Subcutaneous, video-assisted saphenous vein harvest:report of the first 30 cases. Cardio-vasc Surg, 1996, 4(6):771-776.
15.	Desai P, Kiani S, Thiruvanthan N, et al. Impact of the learning curve for endoscopic vein harvest on conduit quality and early graft patency. Ann Thorac Surg, 2011, 91(5):1385-1392.
16.	Rousou LJ, Taylor KB, Lu XG, et al. Saphenous vein conduits harve-sted by endoscopic technique exhibit structural and functional damage. Ann Thorac Surg, 2009, 87(1):62-70.
17.	Yun KL, Wu Y, Aharonian V, et al. Randomized trial of endoscopic versus open vein harvest for coronary artery bypass grafting:six-month patency rates. J Thorac Cardiovasc Surg, 2005, 129(3):496-503.
18.	Perrault LP, Jeanmart H, Bilodeau L, et al. Early quantitative coro-nary angiography of saphenous vein grafts for coronary artery bypass grafting harvested by means of open versus endoscopic saphenectomy:a prospective randomized trial. J Thorac Cardiovasc Surg, 2004, 127(5):1402-1407.
19.	Lopes RD, Hafley GE, Allen KB, et al. Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery. N Engl J Med, 2009, 361(3):235-244.
20.	Zenati MA, Shroyer AL, Collins JF, et al. Impact of endoscopic versus open saphenous vein harvest technique on late coronary artery bypass grafting patient outcomes in the ROOBY (Randomized On/Off Bypass) Trial. J Thorac Cardiovasc Surg, 2011, 141(2):338-344.
21.	Goldman S, Sethi GK, Holman W, et al. Radial artery grafts vs saph-enous vein grafts in coronary artery bypass surgery:a randomized trial. JAMA, 2011, 305(2):167-174.
22.	Bourassa MG. Long-term vein graft patency. Curr Opin Cardiol, 1994, 9(6):685-691.
23.	Soyombo AA, Angelini GD, Bryan AJ, et al. Surgical preparation induces injury and promotes smooth muscle cell proliferation in a culture of human saphenous vein. Cardiovasc Res, 1993, 27(11):1961-1967.
24.	Osgood MJ, Hocking KM, Voskresensky IV, et al. Surgical vein graft preparation promotes cellular dysfunction, oxidative stress, and intimal hyperplasia in human saphenous vein. J Vasc Surg, 2014, 60(1):202-211.
25.	Yang JA, He GW. Surgical preparation abolishes endothelium-derived hyperpolarizing factor-mediated hyperpolarization in the human saphenous vein. Ann Thorac Surg, 1997, 63(2):429-433.
26.	Souza D. A new no-touch preparation technique. Technical notes. Scand J Thorac Cardiovasc Surg, 1996, 30(1):41-44.
27.	Kachlik D, Lametschwandtner A, Rejmontova J, et al. Vasa vasorum of the human great saphenous vein. Surg Radiol Anat, 2003, 24(6):377-381.
28.	Dashwood MR, Anand R, Loesch A, et al. Hypothesis:a potential role for the vasa vasorum in the maintenance of vein graft patency. Angiology, 2004, 55(4):385-395.
29.	Dashwood MR, Savage K, Tsui JC, et al. Retaining perivascular tissue of human saphenous vein grafts protects against surgical and distension-induced damage and preserves endothelial nitric oxide synthase and nitric oxide synthase activity. J Thorac Cardiovasc Surg, 2009, 138(2):334-340.
30.	Souza DS, Christofferson RH, Bomfim V, et al. "No-touch" technique using saphenous vein harvested with its surrounding tissue for coronary artery bypass grafting maintains an intact endothelium. Scand Cardiovasc J, 1999, 33(6):323-329.
31.	Tsui JC, Souza DS, Filbey D, et al. Preserved endothelial integrity and nitric oxide synthase in saphenous vein grafts harvested by a 'no-touch' technique. Br J Surg, 2001, 88(9):1209-1215.
32.	Mannion JD, Marelli D, Brandt T, et al. "No-touch" versus "endo" vein harvest:early patency on symptom-directed catheterization and harvest site complications. Innovations (Phila), 2014, 9(4):306-311.
33.	Souza DS, Dashwood MR, Tsui JC, et al. Improved patency in vein grafts harvested with surrounding tissue:results of a randomized study using three harvesting techniques. Ann Thorac Surg, 2002, 73(4):1189-1195.
34.	Souza DS, Johansson B, Bojo L, et al. Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery:results of a randomized longitudinal trial. J Thorac Cardiovasc Surg, 2006, 132(2):373-378.
35.	Ahmed SR, Johansson BL, Karlsson MG, et al. Human saphenous vein and coronary bypass surgery:ultrastructural aspects of conven-tional and "no-touch" vein graft preparations. Histol Histopathol, 2004, 19(2):421-433.
36.	Souza DS, Bomfim V, Skoglund H, et al. High early patency of saphenous vein graft for coronary artery bypass harvested with surrounding tissue. Ann Thorac Surg, 2001, 71(3):797-800.
37.	Souza DS, Johansson B, Bojo L, et al. Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery:results of a randomized longitudinal trial. J Thorac Cardiovasc Surg, 2006, 132(2):373-378.
38.	Johansson BL, Souza DS, Bodin L, et al. Slower progression of atherosclerosis in vein grafts harvested with 'no touch' technique compared with conventional harvesting technique in coronary artery bypass grafting:an angiographic and intravascular ultrasound study. Eur J Cardiothorac Surg, 2010, 38(4):414-419.
39.	Dreifaldt M, Mannion JD, Bodin L, et al. The no-touch saphenous vein as the preferred second conduit for coronary artery bypass grafting. Ann Thorac Surg, 2013, 96(1):105-111.
40.	Dashwood MR, Loesch A. The saphenous vein as a bypass conduit:the potential role of vascular nerves in graft performance. Curr Vasc Pharmacol, 2009, 7(1):47-57.
41.	Siow RC, Churchman AT. Adventitial growth factor signalling and vascular remodelling:potential of perivascular gene transfer from the outside-in. Cardiovasc Res, 2007, 75(4):659-668.
42.	Maurice G, Wang X, Lehalle B, et al. Modeling of elastic deforma-tion and vascular resistance of arterial and venous vasa vasorum. J Mal Vasc, 1998, 23(4):282-288.
43.	Rousou LJ, Taylor KB, Lu XG, et al. Saphenous vein conduits harve-sted by endoscopic technique exhibit structural and functional damage. Ann Thorac Surg, 2009, 87(1):62-70.
44.	Kiani S, Poston R. Is endoscopic harvesting bad for saphenous vein graft patency in coronary surgery? Curr Opin Cardiol, 2011, 26(6):518-522.
45.	Ahmed SR, Johansson BL, Karlsson MG, et al. Human saphenous vein and coronary bypass surgery:ultrastructural aspects of conven-tional and "no-touch" vein graft preparations. Histol Histopathol, 2004, 19(2):421-433.
46.	Dreifaldt M, Souza DS, Loesch A, et al. The "no-touch" harvesting technique for vein grafts in coronary artery bypass surgery preserves an intact vasa vasorum. J Thorac Cardiovasc Surg, 2011, 141(1):145-150.
47.	Souza DS, Arbeus M, Botelho PB, et al. The no-touch technique of harvesting the saphenous vein for coronary artery bypass grafting surgery. Multimed Man Cardiothorac Surg, 2009, 2009(731):2008. 003624. doi:10.15101mmcts.2008.003624.
48.	Dreifaldt M, Souza D, Bodin L, et al. The vasa vasorum and associ-ated endothelial nitric oxide synthase is more important for saphenous vein than arterial bypass grafts. Angiology, 2013, 64(4):293-299.
49.	Dashwood MR, Gibbins R, Mehta D, et al. Neural reorganisation in porcine vein grafts:a potential role for endothelin-1. Atherosclerosis, 2000, 150(1):43-53.

1. Farkouh ME, Domanski M, Sleeper LA, et al. Strategies for multive-ssel revascularization in patients with diabetes. N Engl J Med, 2012, 367(25):2375-2384.
2. Mohr FW, Morice MC, Kappetein AP, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease:5-year follow-up of the randomised, clinical SYNTAX trial. Lancet, 2013, 381(9867):629-638.
3. 胡盛壽, 鄭哲, 周玉燕.常規與非體外循環冠狀動脈旁路移植術治療冠狀動脈多支病變的對比分析.中國胸心血管外科臨床雜志, 2000, 7(4):221-224.
4. Fitzgibbon GM, Kafka HP, Leach AJ, et al. Coronary bypass graft fate and patient outcome:angiographic follow-up of 5, 065 grafts related to survival and reoperation in 1, 388 patients during 25 years. J Am Coll Cardiol, 1996, 28(3):616-626.
5. Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphe-nous vein and left internal mammary artery grafts after coronary artery bypass surgery:results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol, 2004, 44(11):2149-2156.
6. Manninen HI, Jaakkola P, Suhonen M, et al. Angiographic predic-tors of graft patency and disease progression after coronary artery bypass grafting with arterial and venous grafts. Ann Thorac Surg, 1998, 66(4):1289-1294.
7. Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphe-nous vein and left internal mammary artery grafts after coronary artery bypass surgery:results from a department of veterans affairs cooperative study. J Am Coll Cardiol, 2004, 44(11):2149-2156.
8. Parang P, Arora R. Coronary vein graft disease:pathogenesis and prevention. Can J Cardiol, 2009, 25(2):e57-e62.
9. Verma S, Lovren F, Pan Y, et al. Pedicled no-touch saphenous vein graft harvest limits vascular smooth muscle cell activation:the PATENT saphenous vein graft study. Eur J Cardiothorac Surg, 2014, 45(4):717-725.
10. Samano N, Geijer H, Liden M, et al. The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery:A randomized trial. J Thorac Cardiovasc Surg, 2015, 150(4):880-888.
11. Favaloro RG. Saphenous vein graft in the surgical treatment of coronary artery disease. Operative technique. J Thorac Cardiovasc Surg, 1969, 58(2):178-185.
12. Oddershede L, Andreasen JJ, Brocki BC, et al. Economic evaluation of endoscopic versus open vein harvest for coronary artery bypass grafting. Ann Thorac Surg, 2012, 93(4):1174-1180.
13. Andreasen JJ, Nekrasas V, Dethlefsen C. Endoscopic vs open saphe-nous vein harvest for coronary artery bypass grafting:a prospective randomized trial. Eur J Cardiothorac Surg, 2008, 34(2):384-389.
14. Lumsden AB, Eaves FR, Ofenloch JC, et al. Subcutaneous, video-assisted saphenous vein harvest:report of the first 30 cases. Cardio-vasc Surg, 1996, 4(6):771-776.
15. Desai P, Kiani S, Thiruvanthan N, et al. Impact of the learning curve for endoscopic vein harvest on conduit quality and early graft patency. Ann Thorac Surg, 2011, 91(5):1385-1392.
16. Rousou LJ, Taylor KB, Lu XG, et al. Saphenous vein conduits harve-sted by endoscopic technique exhibit structural and functional damage. Ann Thorac Surg, 2009, 87(1):62-70.
17. Yun KL, Wu Y, Aharonian V, et al. Randomized trial of endoscopic versus open vein harvest for coronary artery bypass grafting:six-month patency rates. J Thorac Cardiovasc Surg, 2005, 129(3):496-503.
18. Perrault LP, Jeanmart H, Bilodeau L, et al. Early quantitative coro-nary angiography of saphenous vein grafts for coronary artery bypass grafting harvested by means of open versus endoscopic saphenectomy:a prospective randomized trial. J Thorac Cardiovasc Surg, 2004, 127(5):1402-1407.
19. Lopes RD, Hafley GE, Allen KB, et al. Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery. N Engl J Med, 2009, 361(3):235-244.
20. Zenati MA, Shroyer AL, Collins JF, et al. Impact of endoscopic versus open saphenous vein harvest technique on late coronary artery bypass grafting patient outcomes in the ROOBY (Randomized On/Off Bypass) Trial. J Thorac Cardiovasc Surg, 2011, 141(2):338-344.
21. Goldman S, Sethi GK, Holman W, et al. Radial artery grafts vs saph-enous vein grafts in coronary artery bypass surgery:a randomized trial. JAMA, 2011, 305(2):167-174.
22. Bourassa MG. Long-term vein graft patency. Curr Opin Cardiol, 1994, 9(6):685-691.
23. Soyombo AA, Angelini GD, Bryan AJ, et al. Surgical preparation induces injury and promotes smooth muscle cell proliferation in a culture of human saphenous vein. Cardiovasc Res, 1993, 27(11):1961-1967.
24. Osgood MJ, Hocking KM, Voskresensky IV, et al. Surgical vein graft preparation promotes cellular dysfunction, oxidative stress, and intimal hyperplasia in human saphenous vein. J Vasc Surg, 2014, 60(1):202-211.
25. Yang JA, He GW. Surgical preparation abolishes endothelium-derived hyperpolarizing factor-mediated hyperpolarization in the human saphenous vein. Ann Thorac Surg, 1997, 63(2):429-433.
26. Souza D. A new no-touch preparation technique. Technical notes. Scand J Thorac Cardiovasc Surg, 1996, 30(1):41-44.
27. Kachlik D, Lametschwandtner A, Rejmontova J, et al. Vasa vasorum of the human great saphenous vein. Surg Radiol Anat, 2003, 24(6):377-381.
28. Dashwood MR, Anand R, Loesch A, et al. Hypothesis:a potential role for the vasa vasorum in the maintenance of vein graft patency. Angiology, 2004, 55(4):385-395.
29. Dashwood MR, Savage K, Tsui JC, et al. Retaining perivascular tissue of human saphenous vein grafts protects against surgical and distension-induced damage and preserves endothelial nitric oxide synthase and nitric oxide synthase activity. J Thorac Cardiovasc Surg, 2009, 138(2):334-340.
30. Souza DS, Christofferson RH, Bomfim V, et al. "No-touch" technique using saphenous vein harvested with its surrounding tissue for coronary artery bypass grafting maintains an intact endothelium. Scand Cardiovasc J, 1999, 33(6):323-329.
31. Tsui JC, Souza DS, Filbey D, et al. Preserved endothelial integrity and nitric oxide synthase in saphenous vein grafts harvested by a 'no-touch' technique. Br J Surg, 2001, 88(9):1209-1215.
32. Mannion JD, Marelli D, Brandt T, et al. "No-touch" versus "endo" vein harvest:early patency on symptom-directed catheterization and harvest site complications. Innovations (Phila), 2014, 9(4):306-311.
33. Souza DS, Dashwood MR, Tsui JC, et al. Improved patency in vein grafts harvested with surrounding tissue:results of a randomized study using three harvesting techniques. Ann Thorac Surg, 2002, 73(4):1189-1195.
34. Souza DS, Johansson B, Bojo L, et al. Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery:results of a randomized longitudinal trial. J Thorac Cardiovasc Surg, 2006, 132(2):373-378.
35. Ahmed SR, Johansson BL, Karlsson MG, et al. Human saphenous vein and coronary bypass surgery:ultrastructural aspects of conven-tional and "no-touch" vein graft preparations. Histol Histopathol, 2004, 19(2):421-433.
36. Souza DS, Bomfim V, Skoglund H, et al. High early patency of saphenous vein graft for coronary artery bypass harvested with surrounding tissue. Ann Thorac Surg, 2001, 71(3):797-800.
37. Souza DS, Johansson B, Bojo L, et al. Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery:results of a randomized longitudinal trial. J Thorac Cardiovasc Surg, 2006, 132(2):373-378.
38. Johansson BL, Souza DS, Bodin L, et al. Slower progression of atherosclerosis in vein grafts harvested with 'no touch' technique compared with conventional harvesting technique in coronary artery bypass grafting:an angiographic and intravascular ultrasound study. Eur J Cardiothorac Surg, 2010, 38(4):414-419.
39. Dreifaldt M, Mannion JD, Bodin L, et al. The no-touch saphenous vein as the preferred second conduit for coronary artery bypass grafting. Ann Thorac Surg, 2013, 96(1):105-111.
40. Dashwood MR, Loesch A. The saphenous vein as a bypass conduit:the potential role of vascular nerves in graft performance. Curr Vasc Pharmacol, 2009, 7(1):47-57.
41. Siow RC, Churchman AT. Adventitial growth factor signalling and vascular remodelling:potential of perivascular gene transfer from the outside-in. Cardiovasc Res, 2007, 75(4):659-668.
42. Maurice G, Wang X, Lehalle B, et al. Modeling of elastic deforma-tion and vascular resistance of arterial and venous vasa vasorum. J Mal Vasc, 1998, 23(4):282-288.
43. Rousou LJ, Taylor KB, Lu XG, et al. Saphenous vein conduits harve-sted by endoscopic technique exhibit structural and functional damage. Ann Thorac Surg, 2009, 87(1):62-70.
44. Kiani S, Poston R. Is endoscopic harvesting bad for saphenous vein graft patency in coronary surgery? Curr Opin Cardiol, 2011, 26(6):518-522.
45. Ahmed SR, Johansson BL, Karlsson MG, et al. Human saphenous vein and coronary bypass surgery:ultrastructural aspects of conven-tional and "no-touch" vein graft preparations. Histol Histopathol, 2004, 19(2):421-433.
46. Dreifaldt M, Souza DS, Loesch A, et al. The "no-touch" harvesting technique for vein grafts in coronary artery bypass surgery preserves an intact vasa vasorum. J Thorac Cardiovasc Surg, 2011, 141(1):145-150.
47. Souza DS, Arbeus M, Botelho PB, et al. The no-touch technique of harvesting the saphenous vein for coronary artery bypass grafting surgery. Multimed Man Cardiothorac Surg, 2009, 2009(731):2008. 003624. doi:10.15101mmcts.2008.003624.
48. Dreifaldt M, Souza D, Bodin L, et al. The vasa vasorum and associ-ated endothelial nitric oxide synthase is more important for saphenous vein than arterial bypass grafts. Angiology, 2013, 64(4):293-299.
49. Dashwood MR, Gibbins R, Mehta D, et al. Neural reorganisation in porcine vein grafts:a potential role for endothelin-1. Atherosclerosis, 2000, 150(1):43-53.

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Progress of Effect of No-touch Technique on Patency Rate of Vein Grafts after Coronary Artery Bypass Grafting

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