Novel surgical device may increase longevity and durability of saphenous vein grafting during CABG
A novel device called venous external support (VEST) may lead to increased longevity and durability of saphenous (leg) vein grafting during coronary artery bypass surgery, according to a new trial done in collaboration with Mount Sinai Health System and conducted by the National Heart, Lung and Blood Institute Cardiothoracic Surgical Trials Network.
The initial phase of the research, which is the first Food and Drug Administration (FDA)-approved trial to test the efficacy of this support device, will prompt further long-term studies that may lead to FDA approval. The results were published in the November 13 issue of Circulation and simultaneously announced as a late-breaking clinical trial during the American Heart Association Scientific Sessions being broadcast from Dallas.
"Vein grafts have a limited durability—about half of them will be closed 10 years after coronary bypass surgery. We need to find a solution to improve outcomes of surgery and prevent patients from having complications and repeated procedures," says Principal Investigator John Puskas, MD, Chair of Cardiovascular Surgery at Mount Sinai Morningside.
Coronary artery bypass surgery, also known as CABG, is the most commonly performed cardiac operation, and improves survival in patients with complex left main and/or multi-vessel coronary artery disease. Surgeons commonly graft healthy saphenous veins onto arteries that feed the heart to bypass clogged vessels and restore blood flow. However, saphenous veins normally experience low pressure in the leg; the higher-pressure environment of the coronary arteries can cause intimal hyperplasia—thickening of their walls—which promotes atherosclerosis and may lead to eventual closure of the vein graft.
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