External stenting for saphenous vein grafts reduce early postoperative graft failure.

Abstract

Multiple studies showed that external stenting mitigates the progression of vein graft disease years after CABG. We used computed tomography to evaluate the effect of external stenting on perioperative vein graft patency. This study assessed graft patency rates of saphenous vein grafts (SVG) in consecutive isolated coronary artery bypass grafting (CABG) patients between 2018 and 2021. Logistic regression analyses were conducted to compare the outcomes of supported and non-supported groups at both patient and graft levels, with age, EurSCORE II, gender, diabetes, and arterial grafts as covariates. Subgroup analyses were performed based on different covariates. The study aimed to provide valuable insights into the clinical outcomes of SVG grafts in CABG patients. The study examined a total of 357 patients who met the inclusion criteria and evaluated 572 vein grafts. Out of these, 150 patients (205 SVGs) received ExSt, while 207 patients (337 SVGs) did not receive ExSt. The study results indicated that the likelihood of overall SVG patency at discharge was higher in the stented group compared to the non-stented group, both at the level of grafts (93.8% vs 87.8%, odds ratio [OR] 2.1; 95% confidence interval [CI] 1.0-4.5; P = 0.05) and at the patient level (90.1% vs 83.5%, OR 1.8; 95% CI, 0.9-3.6; P = 0.1). It is worth noting that the difference between the stented and non-stented groups was most significant in the subgroup that received two arterial grafts (96.5% vs 89.6%, OR 3.2; 95% CI, 1.2-8.4; P = 0.02), and in the subgroup with higher EuroSCORE II (median >1.1) (98.6% vs 88.6%, OR 8.8; 95% CI, 1.1-72.7; P = 0.04). ExSt is associated with improved perioperative SVG patency at both graft and patient levels. Moreover, SVGs to the right territory and high-risk patients appear to have an advantage using ExSt.