Muhammad Abdullah Ali, Umama Alam, Fazia Khattak, Zaryab Bacha, Fatima Sajjad, Asad Iqbal Khattak, Abdullah Afridi, Sufyan Shahid, Maheen Sheraz, Naveed Ahmed Khan, Alifa Sabir, Raheel Ahmed
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Data were extracted on primary outcomes (graft failure incidence per patient, graft occlusion incidence per patient and leg infection) and secondary outcomes (revascularisation, all-cause death, myocardial infarction). Statistical analysis was performed using Review Manager V.5.4, with risk ratios (RRs) calculated for binary outcomes.</p><p><strong>Results: </strong>Seven RCTs involving 4176 patients were included. The NT group showed a significantly lower risk of graft failure incidence per patient (RR=0.74, p=0.0001) and graft occlusion incidence per patient (RR=0.62, p=0.0002) compared with the CON group. However, the NT group had a higher risk of leg infection (RR=1.91, p<0.00001). No significant differences were observed between groups for revascularisation (p=0.46), all-cause death (p=0.87), or myocardial infarction (p=0.95).</p><p><strong>Conclusions: </strong>The no-touch vein harvesting technique is associated with reduced graft failure incidence per patient and graft occlusion incidence per patient compared with conventional harvesting techniques in CABG, though it increases the risk of leg infection. 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引用次数: 0
摘要
目的：本荟萃分析旨在比较非接触式（NT）和传统（CON）静脉采集技术在冠状动脉旁路移植术（CABG）患者中的临床结果。方法：我们按照Cochrane手册和PRISMA（首选系统评价和荟萃分析报告项目）声明的指导方针进行了系统评价和荟萃分析。我们检索了PubMed、Embase和Web of Science，查找比较NT和CON静脉采收技术在CABG患者中的应用的随机对照试验（rct）。主要结局（每个患者的移植物衰竭发生率、每个患者的移植物闭塞发生率和腿部感染）和次要结局（血运重建、全因死亡、心肌梗死）的数据被提取出来。使用Review Manager V.5.4进行统计分析，计算二元结果的风险比（rr）。结果：纳入7项随机对照试验，共4176例患者。与CON组相比，NT组患者移植失败发生率（RR=0.74, p=0.0001）和移植闭塞发生率（RR=0.62, p=0.0002）均显著降低。然而，NT组腿部感染风险较高（RR=1.91）。结论：在CABG中，与传统的静脉采集技术相比，非接触式静脉采集技术可以降低每名患者的移植物衰竭发生率和每名患者的移植物闭塞发生率，尽管它增加了腿部感染的风险。这些发现提示NT是改善移植物通畅的较好技术，但强调需要注意腿部感染。普洛斯彼罗注册号：CRD42025646500。
Comparative efficacy and safety of no-touch versus conventional vein harvesting techniques in coronary artery bypass grafting: a systematic review and meta-analysis.
Objective: This meta-analysis aims to compare the clinical outcomes of the no-touch (NT) and conventional (CON) vein harvesting techniques in patients undergoing coronary artery bypass grafting (CABG).
Methods: We conducted a systematic review and meta-analysis following the guidelines of the Cochrane Handbook and PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement. We searched PubMed, Embase and Web of Science for randomised controlled trials (RCTs) comparing NT and CON vein harvesting techniques in CABG patients. Data were extracted on primary outcomes (graft failure incidence per patient, graft occlusion incidence per patient and leg infection) and secondary outcomes (revascularisation, all-cause death, myocardial infarction). Statistical analysis was performed using Review Manager V.5.4, with risk ratios (RRs) calculated for binary outcomes.
Results: Seven RCTs involving 4176 patients were included. The NT group showed a significantly lower risk of graft failure incidence per patient (RR=0.74, p=0.0001) and graft occlusion incidence per patient (RR=0.62, p=0.0002) compared with the CON group. However, the NT group had a higher risk of leg infection (RR=1.91, p<0.00001). No significant differences were observed between groups for revascularisation (p=0.46), all-cause death (p=0.87), or myocardial infarction (p=0.95).
Conclusions: The no-touch vein harvesting technique is associated with reduced graft failure incidence per patient and graft occlusion incidence per patient compared with conventional harvesting techniques in CABG, though it increases the risk of leg infection. These findings suggest NT as a preferable technique for improving graft patency but highlight the need for caution regarding leg infection.
期刊介绍：
Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.
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