Ali Muhammad Abdullah, Alam Umama, Khattak Fazia, Bacha Zaryab, Sajjad Fatima, Khattak Asad Iqbal, Afridi Abdullah, Shahid Sufyan, Sheraz Maheen, Khan Naveed Ahmed, Sabir Alifa, Ahmed Raheel
Khyber Medical College, Peshawar, N.W.F.P, Pakistan.
Department of Medicine, Khyber Medical College, Peshawar, Pakistan.
Open Heart. 2025 Jul 21;12(2):e003391. doi: 10.1136/openhrt-2025-003391.
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).
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.
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).
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.
CRD42025646500.
本荟萃分析旨在比较冠状动脉旁路移植术（CABG）患者中免接触（NT）与传统（CON）静脉采集技术的临床结局。
我们按照Cochrane手册和PRISMA（系统评价和荟萃分析的首选报告项目）声明的指南进行了系统评价和荟萃分析。我们在PubMed、Embase和Web of Science中检索了比较CABG患者NT和CON静脉采集技术的随机对照试验（RCT）。提取了关于主要结局（每位患者的移植物失败发生率、每位患者的移植物闭塞发生率和腿部感染）和次要结局（血管再通、全因死亡、心肌梗死）的数据。使用Review Manager V.5.4进行统计分析，计算二元结局的风险比（RRs）。
纳入了7项涉及4176例患者的RCT。与CON组相比，NT组每位患者的移植物失败发生率（RR = 0.74，p = 0.0001）和每位患者的移植物闭塞发生率（RR = 0.62，p = 0.0002）显著更低。然而，NT组发生腿部感染的风险更高（RR = 1.91，p < 0.000＜0.00001）。在血管再通（p = 0.46）、全因死亡（p = 0.87）或心肌梗死（p = 0.95）方面，两组之间未观察到显著差异。
与CABG中的传统采集技术相比，免接触静脉采集技术与每位患者的移植物失败发生率和移植物闭塞发生率降低相关，尽管它增加了腿部感染的风险。这些发现表明NT是改善移植物通畅性的优选技术，但强调了对腿部感染需谨慎的必要性。
PROSPERO注册号：CRD42025……646500。 （注：原文注册号最后几位似乎不完整，翻译时保留原文形式）
