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No-touch saphenous vein grafts in coronary artery surgery (SWEDEGRAFT): Rationale and design of a multicenter, prospective, registry-based randomized clinical trial - 19/06/20

Doi : 10.1016/j.ahj.2020.03.009 
Sigurdur Ragnarsson, MD, PhD a, , Mikael Janiec, MD, PhD b, Ivy Susanne Modrau, MD c, Mats Dreifaldt, MD, PhD d, Anders Ericsson, MD, PhD e, Anders Holmgren, MD, PhD f, Henrik Hultkvist, MD, PhD g, Anders Jeppsson, MD, PhD h, Ulrik Sartipy, MD, PhD i, Lisa Ternström, MD, PhD h, M.D. Per Vikholm, PhD b, Domingos de Souza, MD, PhD d, Stefan James, MD, PhD b, Stefan Thelin, MD, PhD b
a Skane University Hospital and Lund University, Lund, Sweden 
b Uppsala University Hospital, Uppsala, Sweden 
c Aarhus University Hospital, Aarhus, Denmark 
d Orebro University Hospital, Orebro, Sweden 
e Blekinge Hospital, Karlskrona, Sweden 
f University Hospital of Umea, Umea, Sweden 
g Linkoping University Hospital, Linkoping, Sweden 
h Sahlgrenska University Hospital, Gothenburg, Sweden 
i Karolinska University Hospital, Stockholm, Sweden 

Reprint requests: Sigurdur Ragnarsson, MD, PhD, Department of Cardiothoracic Surgery, Lund University and Skane University Hospital, Getingevagen 4, SE-221 85 Lund, Sweden.Department of Cardiothoracic SurgeryLund University and Skane University HospitalGetingevagen 4LundSE-221 85Sweden

Abstract

The SWEDEGRAFT study (ClinicalTrials.gov Identifier: NCT03501303) tests the hypothesis that saphenous vein grafts (SVGs) harvested with the “no-touch” technique improves patency of coronary artery bypass grafts compared with the conventional open skeletonized technique. This article describes the rationale and design of the randomized trial and baseline characteristics of the population enrolled during the first 9 months of enrollment.

The SWEDEGRAFT study is a prospective, binational multicenter, open-label, registry-based trial in patients undergoing first isolated nonemergent coronary artery bypass grafting (CABG), randomized 1:1 to no-touch or conventional open skeletonized vein harvesting technique, with a planned enrollment of 900 patients. The primary end point is the proportion of patients with graft failure defined as SVGs occluded or stenosed >50% on coronary computed tomography angiography at 2 years after CABG, earlier clinically driven coronary angiography demonstrating an occluded or stenosed >50% vein graft, or death within 2 years. High-quality health registries and coronary computed tomography angiography are used to assess the primary end point. The secondary end points include wound healing in the vein graft sites and the composite outcome of major adverse cardiac events during the first 2 years based on registry data. Demographics of the first 200 patients enrolled in the trial and other CABG patients operated in Sweden during the same time period are comparable when the exclusion criteria are taken into consideration. RCT# NCT03501303

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 Declarations of interest: none.


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