Rationale and design of a single-center randomized trial to compare the graft patency between the radial artery and the no-touch saphenous vein in coronary artery bypass grafting surgery (GRAFT-CAB Study)

IF 3.7 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS American heart journal Pub Date : 2024-05-06 DOI:10.1016/j.ahj.2024.05.001
Fengqing Zhang MD , Meice Tian MD , Xiaohu Wang MD, Haotian Zhang MD, Xingtong Zhou MD, Rui Liu MD, Rui Liu MD, Zejian Jin MD, Changwei Zhang MD, Xianqiang Wang MD
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Abstract

Background

Previous studies suggested only the radial artery and the No-touch (NT) technique were effective in reducing graft occlusion after coronary artery bypass grafting (CABG) surgery. However, there is no randomized trial comparing these 2 graft conduits. The optimum second conduit for CABG remains undetermined.

Materials and methods

This study is a prospective, single-center randomized clinical trial, aiming to compare the graft patency between the radial artery and the NT vein graft. All patients undergoing isolated CABG with left internal mammary artery (LIMA) plus at least 2 additional grafts will be considered eligible. About 774 cases (516 in the radial artery group and 258 in the NT vein group) will be enrolled in over 1 to 2 years. Participants will be randomized and allocated to two bypass strategies: the LIMA plus 1 radial artery and 1 conventional vein graft, or the LIMA plus 2 NT vein grafts. The primary outcome is graft occlusion at 1 year after CABG evaluated by CT angiography. The secondary outcomes include graft occlusion at 3 and 5 years and major adverse cardiac or cerebrovascular events at 1, 3, and 5 years follow-ups.

Discussion

This study will define whether or not the NT vein has a lower graft occlusion rate than the radial artery in short and mid-term follow-ups, and provide new evidence for the second conduit choice in CABG surgery.

Trial registration

ClinicalTrials.gov NCT06014047. Registered on October 15th, 2023.

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比较冠状动脉旁路移植手术中桡动脉和无触点隐静脉的移植物通畅性的单中心随机试验(GRAFT-CAB 研究)的原理和设计。
背景:以前的研究表明,只有桡动脉和无接触(NT)技术能有效减少冠状动脉旁路移植手术(CABG)后的移植物闭塞。然而,目前还没有对这两种移植物管道进行比较的随机试验。CABG 的最佳第二导管仍未确定:本研究是一项前瞻性、单中心随机临床试验,旨在比较桡动脉和 NT 静脉移植物的通畅性。所有接受左乳内动脉(LIMA)加至少两个额外移植物的孤立 CABG 手术的患者均符合条件。774 例患者(桡动脉组 516 例,NT 静脉组 258 例)将在 1 到 2 年内入组。参与者将被随机分配到两种搭桥策略中:LIMA 加一条桡动脉和一条传统静脉移植物,或 LIMA 加两条 NT 静脉移植物。主要结果是通过 CT 血管造影评估 CABG 术后 1 年的移植物闭塞情况。次要结果包括 3 年和 5 年的移植物闭塞以及 1 年、3 年和 5 年随访时的主要不良心脏或脑血管事件:讨论:这项研究将明确在短期和中期随访中,NT静脉的移植物闭塞率是否低于桡动脉,并为CABG手术中第二导管的选择提供新的证据:试验注册:ClinicalTrials.gov NCT06014047。注册日期:2023 年 10 月 15 日。
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来源期刊
American heart journal
American heart journal 医学-心血管系统
CiteScore
8.20
自引率
2.10%
发文量
214
审稿时长
38 days
期刊介绍: The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.
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