“No-touch” Saphenous Vein Grafts for Coronary Artery Bypass Grafting

抄録

Although saphenous vein grafts (SVGs) are used worldwide as bypass conduits, the long-term graft patency of an SVG is unfavorable compared to that of arterial grafts. Therefore, several attempts have been made to improve graft patency in SVGs. Souza et al. proposed a new SVG harvesting technique, called the “no-touch” SVG (NT-SVG), in which the SVG is harvested with perivascular fat and without high-pressure saline distension. This group reported an excellent rate of graft patency in a milestone randomized clinical trial comparing NT-SVG with conventional SVG (C-SVG). The 16-year patency rate of the NT-SVG was 83%, which was significantly higher than that of the C-SVG and comparable to the 16-year patency rate of 88% for left internal thoracic artery grafts. Several subsequent clinical and basic studies have shown the superiority of the NT-SVG over the C-SVG, and the use of the NT-SVG has become increasingly popular in Japan. However, delayed wound healing is more frequently reported at NT-SVG harvest sites than at C-SVG harvest sites. To overcome this limitation, endoscopic NT-SVG harvesting has been attempted recently. This article reviews recent studies related to NT-SVGs.