SynthesisOpen heart2025
Techniques for harvesting the saphenous vein in coronary artery bypass grafting: a network systematic review and meta-analysis.
Synthesis in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
objectiveThe optimal technique for harvesting the saphenous vein (SVG) in coronary artery bypass grafting (CABG) remains undetermined. This study aimed to assess the efficacy of open vein harvesting (OVH), endoscopic vein harvesting (EVH) and no-touch vein harvesting (NT) in CABG using a network meta-analysis of randomised controlled trials (RCTs).
methodsRCTs evaluating the outcomes in patients undergoing CABG with the SVG using OVH, EVH or NT were identified through a systematic search of PubMed, Web of Science and the Cochrane Central Registry up to August 2025. The outcomes analysed included graft failure, graft occlusion, mortality, revascularisation, myocardial infarction (MI) and leg wound infection rates.
resultsData from 26 RCTs involving 7254 patients meeting the inclusion criteria were analysed. The network meta-analysis indicated that the graft failure rate in the NT group was significantly lower than in the OVH group (relative risk (RR) 0.62; 95% CI 0.40 to 0.96) and the EVH group (RR 0.41; 95% CI 0.21 to 0.80). The graft occlusion rate in the NT group was significantly lower than in the OVH group (RR 0.66, 95% CI 0.52 to 0.84). However, the leg wound infection rate in the NT group was the highest. No significant differences were observed in mortality, revascularisation and MI rates among the three groups.
conclusionNT was associated with lower graft failure and graft occlusion rates, yet it had higher leg wound infection rates, while mortality, revascularisation and MI rates remained comparable among the three techniques. These findings require cautious interpretation, and it is important to balance harvest site complications and the desirability of long-term graft patency.
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