***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES In a long-term r and omised coronary artery bypass grafting ( CABG ) study , the patency rate using a new ' no touch ' ( NT ) vein-graft preparation technique was superior to the conventional ( C ) technique . This cineangiographic and intravascular ultrasound ( IVUS ) sub study examined possible mechanisms . METHODS A total of 45 patients ( 118 grafts ) in the NT group and 46 patients ( 112 grafts ) in the C group had patent grafts at short-term follow-up after 18 months . Thirty-seven patients ( 91 grafts ) in the NT group and 37 patients ( 77 grafts ) in the C group had patent grafts at long-term follow-up after 8.5 years , and were evaluated on a scale from 0 ( normal ) to 2 ( significant stenosis ) by cineangiogram . IVUS was performed in 15 NT grafts and 14 C grafts in the short-term follow-up , and 27 NT grafts and 26 C grafts in the long-term follow-up , in grafts considered normal by the cineangiogram . The grafts were evaluated with respect to lumen volume , intimal thickness , incidence of plaque and plaque components . RESULTS In the short-term follow-up , the cineangiogram showed more normal grafts ( 89.0 % in the NT group compared with 75.0 % in the C group ) , and the number of grafts with stenosis was 11.0 % in the NT group compared with 25.0 % in the C group ( p=0.006 ) . IVUS showed less mean intimal thickness ( 0.43 (0.07)mm vs 0.52 (0.08)mm ; p=0.03 ) , less grafts with considerable intimal hyperplasia ( ≥ 0.9 mm ; 20 % vs 78.6 % ; p=0.011 ) and fewer patients with considerable hyperplasia ( ≥ 0.9 mm ; 25 % vs 100 % ; p=0.007 ) . In the long-term follow-up , the cineangiogram showed more normal grafts , with 91.2 % in the NT group compared with 83.1 % in the C group ; there were fewer grafts with significant stenosis , with 7.7 % in the NT group compared with 15.6 % in the C group ( p=0.14 ) . IVUS showed fewer grafts containing multiple plaques ( 14.8 % vs 50 % ; p=0.008 ) , less advanced plaque with lipid ( 11.8 % vs 63.9 % ; p=0.0004 ) and less maximal plaque thickness ( 1.04 (0.23)mm vs 1.32 (0.25)mm ; p=0.02 ) in the NT group compared with the C group . CONCLUSION The superior long-term patency rate using the NT vein-graft technique at CABG could be explained by a significantly slower progression of atherosclerosis OBJECTIVE Neointimal hyperplasia secondary to vascular smooth muscle cell ( VSMC ) activation limits the long-term patency of saphenous vein grafts ( SVGs ) . We compared markers of vascular injury and VSMC activation in SVGs harvested using the pedicled ' no-touch ' ( NT ) vs the conventional ( CON ) technique . METHODS Patients undergoing coronary artery bypass surgery were enrolled in the PATENT SVG trial ( clinical trials.gov NCT01488084 ) . Patients were r and omly allocated to have SVGs harvested with the NT technique from one leg and the CON method from the other . SVG segments underwent morphometry , histological and electron microscopy assessment s and transcript measurements of VSMC activation and differentiation markers . Leg wound functional recovery and harvest site complications were assessed using a quality -of-life question naire . RESULTS A total of 17 patients ( 65.3 ± 7.3 years ) were enrolled . SVGs harvested using the NT vs CON technique exhibited preserved intimal , medial and adventitial architecture . CON harvest was associated with greater medial Kruppel-like factor 4 transcript levels ( 0.26 ± 0.05 vs 0.11 ± 0.02 , P < 0.05 ) . CON sample s had significantly lower medial serum response factor ( 0.53 ± 0.11 vs 1.44 ± 0.50 , P < 0.05 ) and myocardin ( 0.59 ± 0.08 vs 1.33 ± 0.33 , P < 0.05 ) transcript levels . MicroRNA-145 , an inhibitor of VSMC activation and differentiation , was higher in the NT vs CON sample s ( 1.84 ± 1.03 vs 0.50 ± 0.19 , P < 0.05 ) . Leg assessment scores were worse in the NT legs at 3 months , but similar to CON scores at 12 months . CONCLUSIONS SVGs harvested using the ' NT ' technique exhibit an early molecular and morphological pattern consistent with decreased VSMC activation compared with CON harvesting . Functional leg recovery was similar in both groups at 12 months . Larger studies are required to corroborate these findings BACKGROUND The use of bilateral internal thoracic ( mammary ) arteries for coronary-artery bypass grafting ( CABG ) may improve long-term outcomes as compared with the use of a single internal-thoracic-artery plus vein grafts . METHODS We r and omly assigned patients scheduled for CABG to undergo single or bilateral internal-thoracic-artery grafting in 28 cardiac surgical centers in seven countries . The primary outcome was death from any cause at 10 years . The composite of death from any cause , myocardial infa rct ion , or stroke was a secondary outcome . Interim analyses were prespecified at 5 years of follow-up . RESULTS A total of 3102 patients were enrolled ; 1554 were r and omly assigned to undergo single internal-thoracic-artery grafting ( the single-graft group ) and 1548 to undergo bilateral internal-thoracic-artery grafting ( the bilateral-graft group ) . At 5 years of follow-up , the rate of death was 8.7 % in the bilateral-graft group and 8.4 % in the single-graft group ( hazard ratio , 1.04 ; 95 % confidence interval [ CI ] , 0.81 to 1.32 ; P=0.77 ) , and the rate of the composite of death from any cause , myocardial infa rct ion , or stroke was 12.2 % and 12.7 % , respectively ( hazard ratio , 0.96 ; 95 % CI , 0.79 to 1.17 ; P=0.69 ) . The rate of sternal wound complication was 3.5 % in the bilateral-graft group versus 1.9 % in the single-graft group ( P=0.005 ) , and the rate of sternal reconstruction was 1.9 % versus 0.6 % ( P=0.002 ) . CONCLUSIONS Among patients undergoing CABG , there was no significant difference between those receiving single internal-thoracic-artery grafts and those receiving bilateral internal-thoracic-artery grafts with regard to mortality or the rates of cardiovascular events at 5 years of follow-up . There were more sternal wound complications with bilateral internal-thoracic-artery grafting than with single internal-thoracic-artery grafting . Ten-year follow-up is ongoing . ( Funded by the British Heart Foundation and others ; ART Current Controlled Trials number , IS RCT N46552265 . ) BACKGROUND The use of radial‐artery grafts for  coronary‐artery bypass grafting ( CABG )  may result in better postoperative outcomes than the use of saphenous‐vein grafts . However , r and omized , controlled trials comparing radial‐artery grafts and saphenous‐vein grafts have been individually underpowered to detect differences in clinical outcomes . We performed a patient‐level combined analysis of r and omized , controlled trials to compare radial‐artery grafts and saphenous‐vein grafts for CABG . METHODS Six trials were identified . The primary outcome was a composite of death , myocardial infa rct ion , or repeat revascularization . The secondary outcome was graft patency on follow‐up angiography . Mixed‐effects Cox regression models were used to estimate the treatment effect on the outcomes . RESULTS A total of 1036 patients were included in the analysis ( 534 patients with radial‐artery grafts and 502 patients with saphenous‐vein grafts )  . After a mean ( ±SD ) follow‐up time of 60±30 months , the incidence of adverse cardiac events was significantly lower in association with radial‐artery grafts than with saphenous‐vein grafts ( hazard ratio , 0.67 ; 95 % confidence interval [ CI ] , 0.49 to 0.90 ; P=0.01 ) . At follow‐up angiography ( mean follow‐up , 50±30 months ) , the use of radial‐artery grafts was also associated with a significantly lower risk of occlusion ( hazard ratio , 0.44 ; 95 % CI , 0.28 to 0.70 ; P<0.001 ) . As compared with the use of saphenous‐vein grafts , the use of radial‐artery grafts was associated with a nominally lower incidence of myocardial infa rct ion ( hazard ratio , 0.72 ; 95 % CI , 0.53 to 0.99 ; P=0.04 ) and a lower incidence of repeat revascularization ( hazard ratio , 0.50 ; 95 % CI , 0.40 to 0.63 ; P<0.001 ) but not a lower incidence of death from any cause ( hazard ratio , 0.90 ; 95 % CI , 0.59 to 1.41 ; P=0.68 ) . CONCLUSIONS As compared with the use of saphenous‐vein grafts , the use of radial‐artery grafts for CABG result ed in a lower rate of adverse cardiac events and a higher rate of patency at 5 years of follow‐up . ( Funded by Weill Cornell Medicine and others . OBJECTIVE Conventional harvesting of the saphenous vein in coronary artery bypass surgery produces vessel damage that contributes to graft failure . A novel " no touch " technique provides high short- and long-term patency rates . METHOD This r and omized longitudinal trial compares graft patency of two patient groups undergoing coronary artery bypass surgery .  Conventional : 52 patients had their veins stripped , distended , and stored in saline solution . No-touch :  52 patients had veins removed with surrounding tissue , not distended , and stored in heparinized blood .  Angiographic assessment was performed at mean time 18 months after the operation in 46 patients in the conventional group and 45 patients in the no-touch group and repeated at mean time 8.5 years in 37 patients from both groups . RESULTS The distribution of the grafts to the recipient coronary arteries regarding their size and quality was similar in both groups . The angiographic assessment at 18 months postoperatively showed 89 % conventional versus 95 % no-touch grafts were patent . Repeated angiography at 8.5 years showed a patency rate for the conventional group of 76 % and 90 % for the no-touch group ( P = .01 ) . The multivariate analysis showed that the most important surgical factors for graft patency were the technique of harvesting ( odds ratio= 3.7 , P = .007 ) for the no-touch versus the conventional technique and the vein quality before implantation ( odds ratio = 3.2 , P = .007 ) for veins that were of good quality . By comparison the patency of the thoracic artery grafts was 90 % . CONCLUSION Harvesting the saphenous vein with surrounding tissue provides high short- and long-term patency rates comparable to the left internal thoracic artery BACKGROUND In the past decade , the radial artery has frequently been used for coronary bypass surgery despite concern regarding the possibility of graft spasm . Graft patency is a key predictor of long-term survival . We therefore sought to determine the relative patency rate of radial-artery and saphenous-vein grafts in a r and omized trial in which we controlled for bias in the selection of patients and vessels . METHODS We enrolled 561 patients at 13 centers . The left internal thoracic artery was used to bypass the anterior circulation . The radial-artery graft was r and omly assigned to bypass the major vessel in either the inferior ( right coronary ) territory or the lateral ( circumflex ) territory , with the saphenous-vein graft used for the opposing territory ( control ) . The primary end point was graft occlusion , determined by angiography 8 to 12 months postoperatively . RESULTS Angiography was performed at one year in 440 patients : 8.2 percent of radial-artery grafts and 13.6 percent of saphenous-vein grafts were completely occluded ( P=0.009 ) . Diffuse narrowing of the graft ( 
    Output:
    
Conclusions The NT technique was not associated with improved patency of SVGs at 1-year following CABG while early vein harvest infection was increased .
The aggregated data is supportive of an important reduction of SVG occlusion at 1 year with NT harvesting .