title: Neointima development in externally stented saphenous vein grafts.
abstract: BACKGROUND
  The main limitation of coronary artery bypass grafting (CABG) is rapid neointimal hyperplasia leading to graft failure.
  
  
  OBJECTIVE
  To assess plaque formation in saphenous vein grafts (SVG) covered by an external Dacron stent in comparison with the classical technique.
  
  
  METHODS
  In the study group vein grafts covered by external stent mesh made of Dacron were implanted. An intravascular ultrasonography (IVUS) study was performed in 35 aorto-coronary SVG covered by an external Dacron stent and in 64 normal SVG during the first year after CABG. In each SVG 25 mm of good quality IVUS image, volumes of lumen, plaque (neointima), outer border of the vein graft (external SVG) and adventitia were calculated in three time periods: 0-130 days, 130-260 days and 260-390 days.
  
  
  RESULTS
  Between the first and second time period, lumen volume (mm3) was reduced from 10.33 ±4.4, to 6.80 ±2.23 in the second period and 5.69 ±1.26 in the third one. This effect was much less marked in normal grafts. The corresponding lumen volume (mm3) was: 10.90 ±3.9, 9.15 ±2.94 and 8.92 ±2.93 in consecutive time periods. Plaque volume (mm3) did not change in control grafts during the course of the study, but it increased very significantly in stented grafts from 0.86 ±1.24 in the first period to 2.70 ±1.58 in the second and 3.29 ±2.66 in the third one.
  
  
  CONCLUSIONS
  The experimental technique of implanting SVG covered with an external elastic Dacron stent seems to be inferior to traditional ones. This is probably due to the more complicated process of vein implantation and higher micro-injury occurrence during the surgery.
authors.affiliation: Department of Human Anatomy, Silesian University of Medicine, Katowice, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Węglarz
authors.affiliation: Upper Silesian Cardiology Centre, Silesian University of Medicine, Katowice, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Krejca
authors.affiliation: Upper Silesian Cardiology Centre, Silesian University of Medicine, Katowice, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Trusz-Gluza
authors.affiliation: Upper Silesian Cardiology Centre, Silesian University of Medicine, Katowice, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Bochenek
authors.affiliation: Freelance Cardiovascular Investigator, Katowice, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Konarska-Kuszewska
authors.affiliation: Upper Silesian Cardiology Centre, Silesian University of Medicine, Katowice, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Szydło
authors.affiliation: Department of Human Anatomy, Silesian University of Medicine, Katowice, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kuszewski
authors.affiliation: Freelance Cardiovascular Investigator, Yatton, United Kingdom.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Jackson
authors.affiliation: Bristol Heart Institute, University of Bristol, Bristol, United Kingdom.
authors.forename: Gianni D
authors.initials: GD
authors.lastname: Angelini
authors.affiliation: Department of Human Anatomy, Silesian University of Medicine, Katowice, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Bajor
keywords: coronary artery bypass grafting; intravascular ultrasonography; neointima