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Related Experiment Video

Updated: May 29, 2026

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique

Published on: April 1, 2022

Does a 'no-touch' technique result in better vein patency?

Amir H Sepehripour¹, Omar A Jarral, Alex R Shipolini

¹Department of Cardiothoracic Surgery, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.

Interactive Cardiovascular and Thoracic Surgery

|September 13, 2011

Summary

The no-touch saphenous vein (SV) harvesting technique for coronary artery bypass grafting (CABG) significantly improves graft patency and reduces stenosis compared to conventional methods. This method preserves vein integrity, offering results comparable to the left internal thoracic artery (LITA).

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Area of Science:

Cardiovascular Surgery
Vascular Biology
Graft Patency Research

Background:

Coronary artery bypass grafting (CABG) frequently utilizes the saphenous vein (SV) as a conduit.
Traditional SV harvesting methods may compromise graft integrity and long-term patency.
The 'no-touch' harvesting technique aims to preserve the SV's natural structure and surrounding tissues.

Purpose of the Study:

To evaluate whether the no-touch harvesting technique for SV conduits in CABG leads to superior graft patency rates.
To compare the ultrastructural, mechanical, and cellular properties of SVs harvested with no-touch versus conventional techniques.
To assess long-term angiographical outcomes, including patency and stenosis, for no-touch SV grafts.

Main Methods:

Systematic review of 405 papers, identifying eight studies providing the best evidence.
Analysis of studies examining vein properties (ultrastructure, mechanics, cellular integrity, atherosclerosis) and graft patency.
Comparison of three prospective randomized studies on graft patency and five comparative studies on morphological/cellular analyses.

Main Results:

No-touch SV grafts demonstrated significantly improved patency rates (90% at 8.5 years) compared to conventional harvesting (76%).
Graft stenosis incidence was lower with the no-touch technique (11% vs. 25%).
Morphological and cellular analyses revealed enhanced endothelial integrity, reduced injury, decelerated atherosclerosis, and improved vasa vasorum in no-touch SVs.

Conclusions:

The no-touch SV harvesting technique offers clear enhancements in vessel wall properties at a cellular level.
Angiographical evidence supports superior graft patency and reduced stenosis with the no-touch technique.
No-touch SV graft patency is comparable to that of the left internal thoracic artery (LITA).