Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2026.007
Perioperative outcomes and graft patency in coronary artery bypass grafting (CABG) after no-touch saphenous vein harvesting: A single-center exploratory study
- Department of Cardiovascular and Transplant Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
Background: The no-touch (NT) technique for saphenous vein harvesting aims to preserve vascular integrity and improve graft performance in coronary artery bypass grafting (CABG). However, concerns remain regarding wound healing disorders and local complications at the graft harvest site.
Methods: This prospective observational comparative study included 60 consecutive patients undergoing CABG, allocated to conventional saphenous vein harvesting (CONV, n=30) or the NT technique (NT, n=30). Group allocation was based on routine clinical practice and surgeon preference, without formal randomization. The primary outcome was the incidence of wound healing disorders and local complications at the harvest site. Secondary outcomes included perioperative parameters, major adverse cardiovascular events (MACE), and venous graft patency assessed by computed tomography coronary angiography one year after surgery.
Results: Operative time and aortic cross-clamp time were comparable between groups. Shorter graft harvesting time was observed in the NT group (35 ± 7.5 min vs. 43 ± 9.1 min; P=0.001), along with significantly reduced perioperative blood loss (15 ± 7 mL vs. 40 ± 12.1 mL; P<0.0001). The incidence of subcutaneous hematoma on postoperative day 7 was significantly lower in the NT group (20% vs. 60%; P=0.003). No statistically significant differences were found between groups in wound infection rates, MACE, or venous graft patency at one-year follow-up.
Conclusion: The NT technique for saphenous vein harvesting offers relevant perioperative advantages, including shorter harvesting time, reduced blood loss, and fewer early local complications, without adversely affecting operative time, major adverse cardiac events, wound infection, or one-year graft patency.
Keywords: coronary artery bypass grafting, saphenous vein harvesting, NT technique, wound healing complications, graft patency
Received: January 11, 2026; Revised: March 11, 2026; Accepted: March 13, 2026; Prepublished online: March 24, 2026
References
- Favaloro RG. Saphenous vein autograft replacement of severe segmental coronary artery occlusion: operative technique. Ann Thorac Surg 1968;5(4):334-9. doi: 10.1016/s0003-4975(10)66351-5
Go to original source...
Go to PubMed... - Schwann TA, Habib RH, Wallace A, Shahian DM, O'Brien S, Jacobs JP, Puskas JD, Kurlansky PA, Engoren MC, Tranbaugh RF, Bonnell MR. Operative Outcomes of Multiple-Arterial Versus Single-Arterial Coronary Bypass Grafting. Ann Thorac Surg 2018;105(4):1109-1119. doi: 10.1016/j.athoracsur.2017.10.058
Go to original source...
Go to PubMed... - Dion R, Glineur D, Derouck D, Verhelst R, Noirhomme P, El Khoury G, Degrave E, Hanet C. Complementary saphenous grafting: long-term follow-up. J Thorac Cardiovasc Surg 2001;122(2):296-304. doi: 10.1067/mtc.2001.115419
Go to original source...
Go to PubMed... - Lytle BW, Loop FD, Cosgrove DM, Ratliff NB, Easley K, Taylor PC. Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts. J Thorac Cardiovasc Surg 1985;89(2):248-58
Go to original source... - Xenogiannis I, Zenati M, Bhatt DL, Rao SV, Rodés-Cabau J, Goldman S, Shunk KA, Mavromatis K, Banerjee S, Alaswad K, Nikolakopoulos I, Vemmou E, Karacsonyi J, Alexopoulos D, Burke MN, Bapat VN, Brilakis ES. Saphenous Vein Graft Failure: From Pathophysiology to Prevention and Treatment Strategies. Circulation 2021;144(9):728-45. doi: 10.1161/CIRCULATIONAHA.120.052163
Go to original source...
Go to PubMed... - Shuhaiber JH, Evans AN, Massad MG, Geha AS. Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery. Eur J CardioThorac Surg 2002; 22(3):387-96. doi: 10.1016/s1010-7940(02)00253-1
Go to original source...
Go to PubMed... - Samano N, Geijer H, Liden M, Fremes S, Bodin L, Souza D. The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial. J Thorac Cardiovasc Surg 2015;150(4):880-8. doi: 10.1016/j.jtcvs.2015.07.027
Go to original source...
Go to PubMed... - Souza DS, Dashwood MR, Tsui JC, Filbey D, Bodin L, Johansson B, Borowiec J. Improved patency in vein grafts harvested with surrounding tissue: results of a randomized study using three harvesting techniques. Ann Thorac Surg 2002;73(4):1189-95. doi: 10.1016/s0003-4975(02)03425-2
Go to original source...
Go to PubMed... - Ragnarsson S, Janiec M, Modrau IS, Dreifaldt M, Ericsson A, Holmgren A, Hultkvist H, Jeppsson A, Sartipy U, Ternström L, Per Vikholm MD, de Souza D, James S, Thelin S. No-touch saphenous vein grafts in coronary artery surgery (SWEDEGRAFT): Rationale and design of a multicenter, prospective, registry-based randomized clinical trial. Am Heart J 2020;224:17-24. doi: 10.1016/j.ahj.2020.03.009
Go to original source...
Go to PubMed... - Tian M, Wang X, Sun H, Feng W, Song Y, Lu F, Wang L, Wang Y, Xu B, Wang H, Liu S, Liu Z, Chen Y, Miao Q, Su P, Yang Y, Guo S, Lu B, Sun Z, Liu K, Hu S. No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial. Circulation 2021;144(14):1120-9. doi: 10.1161/CIRCULATIONAHA.121.055525
Go to original source...
Go to PubMed... - L'Ecuyer PB, Murphy D, Little JR, Fraser VJ. The epidemiology of chest and leg wound infections following cardiothoracic surgery. Clin Infect Dis 1996;22(3):424-9. doi: 10.1093/clinids/22.3.424
Go to original source...
Go to PubMed... - DeLaria GA, Hunter JA, Goldin MD, Serry C, Javid H, Najafi H. Leg wound complications associated with coronary revascularization. J Thorac Cardiovasc Surg 1981;81(3):403-7.
Go to original source... - Utley JR, Thomason ME, Wallace DJ, Mutch DW, Staton L, Brown V, Wilde CM, Bell MS. Preoperative correlates of impaired wound healing after saphenous vein excision. J Thorac Cardiovasc Surg 1989;98(1):147-9.
Go to original source... - Human P, Franz T, Scherman J, Moodley L, Zilla P. Dimensional analysis of human saphenous vein grafts: implications for external mesh support. J Thorac Cardiovasc Surg 2009;137:1101-8.
Go to original source... - Stooker W, Niessen HW, Wildevuur WR, et al. Perivenous application of fibrin glue reduces early injury to the human saphenous vein graft wall in an ex vivo model. Eur J Cardiothorac Surg 2002;21:212-17.
Go to original source... - Murphy GJ, Newby AC, Jeremy JY, Baumbach A, Angelini GD. A randomized trial of an external Dacron sheath for the prevention of vein graft disease: the Extent study. J Thorac Cardiovasc Surg 2007;134(2):504-5. doi: 10.1016/j.jtcvs.2007.01.092
Go to original source...
Go to PubMed... - Taggart DP, Webb CM, Desouza A, Yadav R, Channon KM, De Robertis F, Di Mario C. Long-term performance of an external stent for saphenous vein grafts: the VEST IV trial. J Cardiothorac Surg 2018;13(1):117. doi: 10.1186/s13019-018-0803-9
Go to original source...
Go to PubMed... - Athanasiou T, Aziz O, Skapinakis P, Perunovic B, Hart J, Crossman MC, Gorgoulis V, Glenville B, Casula R. Leg wound infection after coronary artery bypass grafting: a meta-analysis comparing minimally invasive versus conventional vein harvesting. Ann Thorac Surg 2003;76(6):2141-6. doi: 10.1016/s0003-4975(03)01435-8
Go to original source...
Go to PubMed... - Siddiqi MS. Saphenous vein harvest wound complications: risk factors, identification, prevention, and management. Chronic Wound Care Manag Res 2016;3:147-56 doi: 10.2147/CWCMR.S82601
Go to original source... - Abbaszadeh M, Arabnia MK, Rabbani A, Mandegar MH, Vahedi S. The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery. Rev Bras Cir Cardiovasc 2008;23(3):317-22. doi: 10.1590/s0102-76382008000300006
Go to original source...
Go to PubMed... - Felisky CD, Paull DL, Hill ME, Hall RA, Ditkoff M, Campbell WG, Guyton SW. Endoscopic greater saphenous vein harvesting reduces the morbidity of coronary artery bypass surgery. Am J Surg 2002;183(5):576-9. doi: 10.1016/s0002-9610(02)00835-8
Go to original source...
Go to PubMed... - Allen KB, Griffith GL, Heimansohn DA, Robison RJ, Matheny RG, Schier JJ, Fitzgerald EB, Shaar CJ. Endoscopic versus traditional saphenous vein harvesting: a prospective, randomized trial. Ann Thorac Surg 1998;66(1):26-31; discussion 31-2. doi: 10.1016/s0003-4975(98)00392-0
Go to original source...
Go to PubMed... - Kopjar T, Ivankovic S, Luiz Lima M, Botelho Prinheiro B, Dashwood MR. Endoscopic or No-Touch Vein Harvesting for CABG: What is Best for the Patient?. Braz J Cardiovasc Surg 2016;31(6):461-4. doi:10.5935/1678-9741.20160091
Go to original source...
Go to PubMed... - Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019;40:87-165.
Go to original source...
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.




