EXTERNAL STENTING FOR SAPHENOUS VEIN GRAFTS IN CORONARY ARTERY BYPASS GRAFTING: A SINGLE-CENTER EXPERIENCE

The saphenous vein is a commonly used conduit in coronary artery bypass grafting. This work aims to assess our experience with the external stenting of vein grafts with Venous External SupporT (VEST) device (Vascular Graft Solutions, Tel Aviv, Israel) in patients undergoing coronary artery bypass grafting (CABG). We selected twelve consecutive patients receiving a total of 13 individual saphenous vein grafting with VEST system. Nine patients received individual saphenous vein graft to the right coronary artery/posterior descending artery (PDA); three patients received individual saphenous vein graft to the left coronary obtuse marginal artery and one patient received individual saphenous vein bypass in both left and right territory. Harvesting of greater saphenous vein was performed with the ligature of using 3/0 silk suture or titanium micro-clips to prevent inadvertent avulsions during the position of the device and, therefore possible bleedings. A mark was placed every 5 cm along the vein to measure the length of the graft. All saphenous vein-to-aorta proximal anastomosis were performed using single aortic cross clamping technique to reduce aortic manipulation. At mean follow-up time of 2 years the graft patency assessed by CT coronary angiogram (CTCA) was 100%. External stenting of saphenous vein grafts has been shown to mitigate saphenous vein graft remodeling, reduce diffuse intimal hyperplasia, and improve lumen uniformity of saphenous vein grafts. In our opinion external stenting for saphenous vein grafts is a safe and easily reproducible option.