External stenting of vein grafts in coronary artery bypass grafting: interim results from a two centers prospective study

Journal of Cardiothoracic Surgery

Alessandro Bellisaro¹  Ruggero De Paulis¹  Luca Paolo Weltert²  Katia Audisio³  Gianluca Bardi³  Roberto Flocco³  Paolo Centofanti³ 

[1] Heart Surgery Unit, European Hospital, 700, Via portuense, 00149, Rome, Italy;Heart Surgery Unit, European Hospital, 700, Via portuense, 00149, Rome, Italy;Department of Statistics, Saint Camillus International University of Health and Medical Sciences, 8, Via di Sant’Alessandro, 00131, Rome, Italy;Heart Surgery Unit, Mauriziano Hospital, 62, Largo Filippo Turati, 10128, Turin, Italy;

关键词: Coronary artery bypass grafting;    Myocardial revascularization;    Vein grafts;    Vein graft disease;    Venous external stent;   

DOI  :  10.1186/s13019-021-01406-0

来源: Springer

【 摘 要 】

Backgroundprevious studies evaluating external stents for saphenous vein grafts (SVG) in CABG were limited to on-pump isolated CABG and single grafting technique with one external stent per patient. The objective of this prospective study was to evaluate the safety and the short-term performance of external stents in a heterogeneous group of patients who underwent on- and off-pump CABG, single and sequential grafting.Methods102 patients undergoing CABG were enrolled in two centers. All patients received internal mammary artery to the left anterior descending artery and additional arterial and/or venous grafts. In each patient, at least one SVG was supported with an external stent. Grafts’ patency and SVG lumen uniformity were assessed using CT angiography at a pre-defined time window of 6–12 months post procedure. All patients were prospectively followed-up via phone call and/or visit every 6 months for Major Adverse Cardiac and Cerebrovascular Events.Results51 patients (50%) underwent off-pump CABG and 23 patients (23%) were grafted with bilateral internal mammary arteries. Each patient received one or more SVG grafted in a sequential technique (44%) or as a single graft (56%). All SVG were externally stented in 84% of patients and in 16% (n = 16) one SVG was stented and one remained unsupported. At 6–12 months, patency rates of LIMA, RIMA, externally stented SVG and none-stented SVG were 100, 100, 98 and 87.5% respectively. 90% of the externally stented SVG had uniform lumen compared to 37% of the non-stented SVG. Clinical follow-up was completed for all patients with a mean duration of 20 months (range 6–54 months). During follow up period, one patient experienced myocardial infarction due to occlusion of the LIMA-LAD graft and one patient experienced a transient ischemic attack.ConclusionsExternal stenting of SVG is feasible and safe in CABG setting which includes off pump CABG and sequential SVG grafting and associated with acceptable early patency rates.Trial registrationStudy was registered at ClinicalTrials.gov. NCT01860274 (initial release 20.05.2013).

【 授权许可】

CC BY