To the Editor We read the interesting articles by Lamy et al1 and Gaudino et al.2 Lamy et al1 conducted a post hoc analysis of the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial showing that skeletonization of the internal thoracic artery (ITA) vs pedicled technique was associated with a higher rate of graft occlusion and worse outcomes at 1 year (mainly driven by revascularization). Similar findings came from a new post hoc analysis of the Arterial Revascularization Trial by Gaudino et al2; all-cause mortality at 10 years was not different between patients with skeletonization ITA and pedicled ITA, but the rate of adverse cardiovascular events was higher in the skeletonized group.