- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03126409
No-Touch Versus Conventional Saphenous Vein Harvesting Technique
A Multicenter Randomized Trial to Compare the Graft Patency Between No-Touch Vein Harvesting Technique and Conventional Approach in Coronary Artery Bypass Graft Surgery: the PATENCY Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
CABG is still the treatment of choice for ischemic heart disease. However, restenosis or occlusion may occur to graft vessels, leading to postoperative myocardial ischemia and subsequent clinical events. Long-term angiographic follow-up demonstrated that vein graft restenosis and occlusion are common among those receiving CABG, with a vein graft patency of less than 50% at 15 years postoperatively. Besides, it is found that graft occlusion may occur as early as 3 months after the surgery. It is, therefore, a major priority to improve the short-term postoperative vein graft patency so as to achieve better prognosis for patients.
Saphenous vein, the currently most frequently used graft material, occupies over 70% of all graft vessels.
Multiple factors may contribute to the early restenosis or occlusion of the vein grafts, including anastomosis technique, graft vessel quality, target lesion site and degree of stenosis, perioperative coagulating function, etc. The No-Touch technique focuses on saphenous vein graft harvesting, featured by preserving the surrounding tissue of the vein while at the same time avoiding manual distension. This technique has been reported associated with better short and long-term vein graft patency. However, these results mostly came from small-scale, single-center studies, therefore could hardly be recognized as high-level evidence for generalization of the technique.
This prospective multi-center study aims to compare the short-term saphenous vein graft patency harvested by the No-Touch technique and the conventional approach. This study will consecutively enroll 2000 patients undergoing isolated on-pump/off-pump CABG in 7 hospitals of China. After obtaining informed written consent, participants will be randomly allocated to either the No-Touch harvesting or conventional approach group. At baseline, participants will be interviewed to collect detailed information about on demographics, socioeconomic status, cardiovascular risk factors, clinical characteristics, treatments, in-hospital outcomes, general and disease-specific quality of life, function and mental status. During the follow-ups, the investigators will collect information about clinical outcomes events, long-term treatments, function, quality of life, symptoms, and medical care during the recovery period. All participants will be invited for 64-slice multi-slice computed tomography angiography (MSCTA) analysis at 3 months post-operatively for graft patency evaluation.
The patients, data adjudicators and CT reviewers will be blinded to the study. Due to the nature of this study, the operating surgeons, anesthetists and other operative room staff will not be blind in this study.
By comparing the short-term graft patency between the No-Touch and conventional vein harvesting groups, this study will contribute major evidence of the possible superiority of this technique, so as to improve patient outcomes after CABG surgery.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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Beijing
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Beijing, Beijing, China, 100037
- Fuwai Hospital Chinese Academay of Medical Science and National Center for Cardiovascular Diseases
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients receiving first time isolated on-pump/off-pump CABG
- Patients with at least one available saphenous vein graft
Exclusion Criteria:
- Need for a concomitant cardiac or vascular surgeries (i.e. valve repair or replacement, Maze surgery)
- Redo-CABG
- Emergent CABG
- Using vascular stapler for anastomosis
- Endarterectomy of coronary artery during surgery
- Left ventricular repair due to ventricular aneurysm
- Combined with malignant tumor or other severe systemic conditions
- Severe renal insufficiency (i.e. creatinine >200 μmol/L)
- Contraindications for dual antiplatelet therapy, such as active gastroduodenal ulcer
- Participants of another ongoing clinical trials
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: No-Touch vein harvesting technique
During saphenous vein harvesting, surrounding tissue of the vein is preserved, and manual distension of the vein graft is avoided
|
The No-Touch technique focuses on saphenous vein graft harvesting, featured by preserving the surrounding tissue of the vein while at the same time avoiding manual distension.
|
Active Comparator: Conventional vein harvesting
During saphenous vein harvesting, surrounding tissue of the vein is stripped off, and manual distension is routinely performed
|
During saphenous vein harvesting, surrounding tissue of the vein is stripped off, and manual distension is routinely performed
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prevalence of graft occlusion
Time Frame: 3 month after procedure
|
All participants will be invited to return to their operating hospitals for 64-slice multi-slice computed tomography angiography to determine patencies of the graft vessels.
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3 month after procedure
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prevalence of graft occlusion
Time Frame: 1 year after procedure
|
All participants will be invited to return to their operating hospitals for 64-slice multi-slice computed tomography angiography to determine patencies of the graft vessels.
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1 year after procedure
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Overall major adverse cardiac or cerebrovascular events (MACCE) rate
Time Frame: 3 month and 1 year after procedure
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MACCE includes death, myocardial infarction, stroke and/or repeat revascularization
|
3 month and 1 year after procedure
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Cardiac death
Time Frame: 3 month and 1 year after procedure
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death from any heart disease
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3 month and 1 year after procedure
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Documented non-lethal myocardial infarction
Time Frame: 3 month and 1 year after procedure
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Myocardial infarction is defined according to the most recent guideline
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3 month and 1 year after procedure
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Stroke
Time Frame: 3 month and 1 year after procedure
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an acute symptomatic episode of focal or global neurological dysfunction caused by brain, spinal, or retinal vascular injury as a result of hemorrhage or infarction
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3 month and 1 year after procedure
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Target lesion revascularization
Time Frame: 3 month and 1 year after procedure
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CABG or percutaneous coronary intervention
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3 month and 1 year after procedure
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Recurrence of Angina
Time Frame: 3 month and 1 year after procedure
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recurrence of unstable angina
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3 month and 1 year after procedure
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Collaborators and Investigators
Publications and helpful links
General Publications
- Wang X, Tian M, Zheng Z, Gao H, Wang Y, Wang L, Hu S. Rationale and design of a multicenter randomized trial to compare the graft patency between no-touch vein harvesting technique and conventional approach in coronary artery bypass graft surgery. Am Heart J. 2019 Apr;210:75-80. doi: 10.1016/j.ahj.2018.11.011. Epub 2018 Dec 6.
- 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, Zhang C, Wu Y, Xu H, Zhao W, Han C, Zhou X, Wang E, Huo X, Hu S. No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial. Circulation. 2021 Oct 5;144(14):1120-1129. doi: 10.1161/CIRCULATIONAHA.121.055525. Epub 2021 Sep 13.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20170414
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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