title: Saphenous Vein Graft Wrapping by Nitinol Mesh: A Word of Caution.
abstract: BACKGROUND
  Saphenous vein conduits are still used in a large proportion of coronary artery bypass graft (CABG) operations. A recently commercialized nitinol mesh seems to improve venous graft patency. The aim of this study was to control nitinol mesh vein graft patency in a series of isolated CABG patients by computed tomographic (CT) scan.
  
  
  METHODS
  In 25 patients (mean age: 61.0 ± 9.65 years), operated for isolated CABG, the eSVS nitinol mesh (Kips Bay Medical Inc., Minneapolis, Minnesota, United States) was used to wrap one vein graft in each patient. Nitinol mesh vein graft was used to revascularize the right coronary (4 patients; 16%), the posterior descending (18 patients; 72%), and the obtuse marginal (3 patients; 12%) arteries. CT scans were performed at 1, 6, and 12 months postoperatively.
  
  
  RESULTS
  The procedure was uneventful in all patients. CT controls showed an overall patency rate of 86.9, 42.7, and 34.1% at 1, 6, and 12 months, respectively. The 4 mm mesh had a significantly higher patency rate at 12 months (83.33%) than the 3.5 mm one which showed quite unsatisfactory results (20%) (p = 0.02). Patients with graft occlusion underwent stress testing which was mildly positive in two cases. One of them underwent a percutaneous revascularization.
  
  
  CONCLUSIONS
  Despite promising early results, use of nitinol mesh for saphenous veins was disappointing in our experience. Further refinements are probably needed.
authors.affiliation: Department of Cardiac Surgery, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rescigno
authors.affiliation: Department of Cardiac Surgery, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Aratari
authors.affiliation: Department of Cardiac Surgery, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Sacha Marco
authors.initials: SM
authors.lastname: Matteucci
authors.affiliation: Department of Invasive Cardiology, Ospedali Riuniti Marche Nord, Pesaro, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Parisi
authors.affiliation: Department of Cardiac Surgery, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Gironi
authors.affiliation: Department of Radiology, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Schicchi
authors.affiliation: Department of Cardiac Surgery, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Alfonso
authors.affiliation: Department of Pharmacy, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cola
authors.affiliation: Department of Cardiac Surgery, Ospedali Riuniti di Ancona, Ancona, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Torracca
mesh_terms: D000368:Aged; D000497:Alloys; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D013526:Surgical Mesh; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D000497:Alloys; C013616:nitinol