Harvesting techniques of the saphenous vein graft for coronary artery bypass: Insights from a network meta-analysis.
coronary artey bypass grafting
endoscopic vein harvesting
no-touch vein harvesting
saphenous vein
Journal
Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
19
07
2021
received:
25
05
2021
accepted:
08
08
2021
pubmed:
3
9
2021
medline:
5
10
2021
entrez:
2
9
2021
Statut:
ppublish
Résumé
The optimal harvesting technique of saphenous vein (SVG) in coronary artery bypass grafting (CABG) is still to be elucidated. The present study aimed to compare the methods of SVG harvesting technique, which were open vein harvesting (OVH), endoscopic vein harvesting (EVH), and no-touch vein harvesting (NT), using a network meta-analysis of randomized controlled trials (RCTs), and propensity-score matched (PSM) studies. MEDLINE and EMBASE were searched through April 2021 to identify RCTs and PSM studies that investigated the outcomes in patients who underwent CABG with the SVG using one of three methods; OVH, EVH, and NT. The outcomes of interest were all-cause mortality, the rates of revascularization, and graft failure. Risk ratios (RRs) were extracted for the rates of graft failure, and hazard ratios (HRs) were extracted for all-cause mortality and the rates of revascularization. Eligible seven RCT and five PSM studies were identified which enrolled a total of 8111 patients. All-cause mortality was significantly lower in patients with EVH compared with OVH (HR [95% confidence interval (CI)] =0.77 [0.65-0.92], p = .0032). The rates of revascularization were similar among the groups. The rate of graft failures was significantly lower in patients with NT compared with OVH (HR [95% CI] =0.54 [0.32-0.90], p = .019) and with EVH (HR [95% CI] =0.39 [0.17-0.86], p = .023). NT vein harvesting is favorable for graft patency, and OVH showed higher all-cause mortality than EVH. Further well-powered RCTs are needed to confirm our findings.
Types de publication
Journal Article
Meta-Analysis
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
4369-4375Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
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