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Abstract：
OBJECTIVE: This retrospective study was conducted to evaluate the impact of saphenous vein (SV) harvesting with versus without perivascular tissue on the 5-year angiographic patency in coronary artery bypass grafting.
METHODS: Among the 944 patients who received coronary artery bypass grafting between 2010 and 2015, 579 patients who received off-pump coronary artery bypass grafting using 1 SV as a Y-composite graft based on the in situ left internal thoracic artery were enrolled. SV harvesting was performed using no-touch technique without perivascular tissue (the NoPVT group) in 342 patients and with perivascular tissue (the PVT group) in 237 patients. Follow-up duration was 84.0 months (interquartile range 66.5-105.4). Propensity score matching was performed, and long-term clinical outcomes and angiographic patency were compared.
RESULTS: The average number of distal anastomoses per patient was comparable between the groups, although more SV grafts were anastomosed to left anterior descending territory in the PVT group than in the NoPVT group. Overall survival and cumulative incidence of cardiac death were comparable between the groups, whereas cumulative incidence of target vessel revascularization (1.3% vs 4.3% at 5 year, P = 0.009) and that of major adverse cardiac events (7.3% vs 9.9% at 5 year, P = 0.035) were lower in the PVT group than in the NoPVT group. One-year and 5-year angiographic patency rates of the SV grafts were higher in the PVT group than in the NoPVT group [97.0% vs 91.7% (P = 0.004) and 96.3% vs 89.9% (P = 0.007), respectively].
CONCLUSIONS: SV grafts harvested using no-touch technique with perivascular tissue further improved the 5-year patency of SV composite grafts compared with those without perivascular tissue.
METHODS: Among the 944 patients who received coronary artery bypass grafting between 2010 and 2015, 579 patients who received off-pump coronary artery bypass grafting using 1 SV as a Y-composite graft based on the in situ left internal thoracic artery were enrolled. SV harvesting was performed using no-touch technique without perivascular tissue (the NoPVT group) in 342 patients and with perivascular tissue (the PVT group) in 237 patients. Follow-up duration was 84.0 months (interquartile range 66.5-105.4). Propensity score matching was performed, and long-term clinical outcomes and angiographic patency were compared.
RESULTS: The average number of distal anastomoses per patient was comparable between the groups, although more SV grafts were anastomosed to left anterior descending territory in the PVT group than in the NoPVT group. Overall survival and cumulative incidence of cardiac death were comparable between the groups, whereas cumulative incidence of target vessel revascularization (1.3% vs 4.3% at 5 year, P = 0.009) and that of major adverse cardiac events (7.3% vs 9.9% at 5 year, P = 0.035) were lower in the PVT group than in the NoPVT group. One-year and 5-year angiographic patency rates of the SV grafts were higher in the PVT group than in the NoPVT group [97.0% vs 91.7% (P = 0.004) and 96.3% vs 89.9% (P = 0.007), respectively].
CONCLUSIONS: SV grafts harvested using no-touch technique with perivascular tissue further improved the 5-year patency of SV composite grafts compared with those without perivascular tissue.
摘要：
目的：这项回顾性研究旨在评估在冠状动脉旁路移植术（CABG）中，有与没有血管周围组织的隐静脉（SV）采集对5年血管造影通畅性的影响。
方法：在2010年至2015年期间接受CABG的944例患者中，579例患者接受非体外循环CABG，使用一个SV作为基于原位左胸廓内动脉的Y复合移植物。342例患者使用无接触技术（NoPVT组）和237例患者使用无血管周围组织（PVT组）进行SV采集。随访时间为84.0个月[四分位距，66.5-105.4].进行倾向得分匹配，比较了长期临床结局和血管造影通畅性.
结果：每个患者的远端吻合术的平均数量在组间相当，尽管与NoPVT组相比，PVT组与左前降支区吻合的SV移植物更多。两组之间的总生存率和心脏死亡的累积发生率相当，而靶血管血运重建的累积发生率(5年时为1.3%vs4.3%,P=0.009）和主要不良心脏事件（5年时为7.3％vs9.9％，P=0.035），PVT组低于NoPVT组。PVT组的1年和5年血管造影开放率高于NoPVT组（97.0%vs91.7%[P=0.004]和96.3%vs89.9%[P=0.007]，分别)。
结论：与血管周围组织相比，使用无接触技术收获的SV移植物进一步改善了SV复合移植物的5年通畅性。
方法：在2010年至2015年期间接受CABG的944例患者中，579例患者接受非体外循环CABG，使用一个SV作为基于原位左胸廓内动脉的Y复合移植物。342例患者使用无接触技术（NoPVT组）和237例患者使用无血管周围组织（PVT组）进行SV采集。随访时间为84.0个月[四分位距，66.5-105.4].进行倾向得分匹配，比较了长期临床结局和血管造影通畅性.
结果：每个患者的远端吻合术的平均数量在组间相当，尽管与NoPVT组相比，PVT组与左前降支区吻合的SV移植物更多。两组之间的总生存率和心脏死亡的累积发生率相当，而靶血管血运重建的累积发生率(5年时为1.3%vs4.3%,P=0.009）和主要不良心脏事件（5年时为7.3％vs9.9％，P=0.035），PVT组低于NoPVT组。PVT组的1年和5年血管造影开放率高于NoPVT组（97.0%vs91.7%[P=0.004]和96.3%vs89.9%[P=0.007]，分别)。
结论：与血管周围组织相比，使用无接触技术收获的SV移植物进一步改善了SV复合移植物的5年通畅性。
