{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:17:36Z","timestamp":1787314656098,"version":"build-2736575974"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T00:00:00Z","timestamp":1608163200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Local research committee and Nyckelfonden","award":["OLL-506851"],"award-info":[{"award-number":["OLL-506851"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Concerns have been raised regarding whether skeletonization of the internal thoracic artery could damage the graft and thereby reduces its patency. The objective of this study was to compare patency rates at mid- and long-term follow-up between pedicled and skeletonized left internal thoracic artery grafts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized controlled trial included 109 patients undergoing coronary artery bypass surgery. The patients were assigned to receive either one pedicled or one skeletonized left internal thoracic artery graft to the left anterior descending artery. Follow-up was performed at 3 years with conventional angiography, and at 8 years with computed tomography angiography. Differences between patency rates were analyzed with Fisher\u2019s exact test and a generalized linear model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patency rates for pedicled and skeletonized left internal thoracic artery grafts were 46\/48 (95.8%) versus 47\/52 (90.4%), p\u2009=\u20090.44 at 3 years, and 40\/43 (93.0%) versus 37\/41 (90.2%), p\u2009=\u20090.71 at 8 years, respectively. The difference in patency rates for pedicled and skeletonized grafts was 5.4% (95% confidence interval: \u22124.2\u201314.5) at 3 years and 2.8% (95% confidence interval: \u22129.9\u201314.1) at 8 years. All failed grafts, except for one with a localized stenosis, were anastomosed to native coronary arteries with a stenosis less than 70%. Three patients suffered sternal wound infections (two in the pedicled group, one in the skeletonized group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The skeletonization technique can be used without jeopardizing the patency of the left internal thoracic artery. The most important factor in graft failure was target artery stenosis below 70%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0218492320983491","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:11:28Z","timestamp":1608250288000},"page":"490-497","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Pedicled versus skeletonized internal thoracic artery grafts: a randomized trial"],"prefix":"10.1177","volume":"29","author":[{"given":"Mats","family":"Dreifaldt","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4249-8401","authenticated-orcid":false,"given":"Ninos","family":"Samano","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery and University Health Care Research Center, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kan","family":"Geijer","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Lid\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lennart","family":"Bodin","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine; Unit of Intervention and Implementation Research, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domingos","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"bibr1-0218492320983491","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199601253340402"},{"key":"bibr2-0218492320983491","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38820-8"},{"key":"bibr3-0218492320983491","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0b013e32834b9f87"},{"key":"bibr4-0218492320983491","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06069-X"},{"key":"bibr5-0218492320983491","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.03.056"},{"key":"bibr6-0218492320983491","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.615427"},{"key":"bibr7-0218492320983491","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.01.102"},{"key":"bibr8-0218492320983491","unstructured":"Dreifaldt M, Mannion JD, Geijer H, et\u00a0al. 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