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No-touch vs conventional vein harvesting in coronary artery bypass grafting: 3-year follow-up dataset from the multi-center randomized PATENCY trial

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Jun 25, 2026 version files 821.04 KB

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Abstract

Objective: To assess the 3-year outcomes of the No-touch vein harvesting technique in coronary artery bypass grafting surgery compared with the conventional approach.

Design: Three-year extended follow-up of the randomized Graft Patency Between the No-touch Vein Harvesting Technique and Conventional Approach in Coronary Artery Bypass Graft Surgery (PATENCY) trial.

Setting: 7 cardiac surgery centers in China; enrollment between April 2017 and June 2019.

Participants: 2655 participants aged 18 and older undergoing isolated coronary artery bypass grafting surgery.

Interventions: Patients were randomly assigned 1:1 into the No-touch vein harvesting technique group or the conventional approach group during surgery and followed up.

Main Outcome Measures: Vein graft occlusion (based on CT angiography) at 3 years.

Results: Of all the participants with a mean age of 61±8 years and with 22% being women, 99.4% (2621) attended the 3-year follow-up visit, while 86.5% (2281) received CT angiography. At 3 years, the No-touch group showed a significantly lower vein graft occlusion rate (5.7% vs. 9.0%, p<0.001) compared to the conventional group (OR, 0.62; 95% CI, 0.48-0.80), with absolute risk difference (ARD) of -3.2% (95%CI, -5.0% to -1.4%). The ITT analysis, including all 2,655 randomized patients with multiple imputations for missing data, demonstrated consistent findings, with occlusion rates of 5.8% in the No-touch group versus 8.9% in the conventional group (OR, 0.63; 95% CI, 0.50-0.80; ARD, -3.1%; 95% CI, -4.7% to -1.5%; P < 0.001). These results confirm the robustness of the No-touch technique in reducing vein graft occlusion.

Conclusions: The No-touch technique consistently and robustly reduced the risk of vein graft occlusion and several cardiac events by one-third to one-half within 3 years after CABG surgery.

Trial Registration: ClinicalTrials.gov Identifier: NCT03126409.