No-Touch Vein Harvesting Shows No Significant Clinical Benefit in SWEDEGRAFT Follow-Up

No-touch saphenous vein harvesting preserves perivascular tissue and may improve graft patency, but its long-term clinical benefit remains uncertain. A prespecified extended follow-up of the SWEDEGRAFT randomized trial compared no-touch with conventional harvesting at nine cardiac surgery centers in Sweden and Denmark. Of 902 patients randomized before primary, nonemergent, isolated CABG, 900 were included in the modified intention-to-treat analysis. Outcomes were identified through national population-based registries.

Over a median 6.46 years, the primary composite of all-cause death, myocardial infarction, or repeat revascularization occurred in 90 of 454 patients assigned to no-touch harvesting and 91 of 446 assigned to conventional harvesting (19.8% vs 20.4%; hazard ratio, 0.98; 95% CI, 0.73–1.31; P=.90). The adjusted seven-year risk difference was −0.8 percentage points (95% CI, −6.6 to 4.6). None of the individual components differed significantly, and prespecified subgroup analyses showed no heterogeneity in treatment effect.

These findings do not establish a net clinical benefit from routine no-touch harvesting, particularly alongside the previously reported excess of leg wound complications. The confidence intervals do not exclude clinically relevant benefit or harm, so the findings should not be interpreted as proof of equivalence. Women represented only 12.0% of participants. This update is based on the abstract; full text was not available.