Saphenous Vein Coronary Bypass Grafts Research Articles

S2558 An Unusual Cause of Upper Gastrointestinal Bleed: Temporary Epicardial Pacing Wire

Introduction: A temporary epicardial pacing wire (TEPW) is frequently placed during cardiac surgery to treat postoperative arrhythmias. Gastrointestinal (GI) complications from TEPW are rare, and only a few have been described. Here we describe a rare case of upper GI bleed from TEPW traversing the stomach. Case Description/Methods: A 76-year-old male with a past medical history of coronary artery disease (CAD) status posts two stents, myocardial infarction, chronic kidney disease, hypertension, and stroke presented to the emergency department with chest pain. The patient had a non-ST-elevation myocardial infarction (NSTEMI); coronary angiography showed multivessel CAD. He underwent coronary artery bypass grafting (CABG), following which the patient had 1200cc dark blood drained through the nasogastric tube. The patient underwent esophagogastroduodenoscopy (EGD), which showed a significant amount of fresh blood (Figure A) and a suspicious linear object entering and exiting the gastric body (Figure B). He underwent a celiac and left gastric artery angiogram with embolization of the injured branch of the left gastric artery. The foreign body removed from the stomach was identified as right ventricle TEPW. Repeat EGD showed no active bleeding. Discussion: Epi-myocardium of the atria and ventricle are common sites for TEPW placement during cardiac surgery. They are tunneled to the outside through the left subcoastal margin. Poor sensing or capture, dislodgement, or retention are the most common complications. Other complication include bleeding from the right ventricular laceration with tamponade, avulsion of a side branch from a saphenous vein coronary bypass graft, and perforation of the superior epigastric artery. GI complications from this procedure are rare. Few reports of bowel perforation presenting as acute abdomen have been described. A case of dyspepsia due to gastric wall injury caused by the migration of TEPW into the gastric cavity has been described. To our knowledge, no case of upper GI bleed secondary to pacemaker wire misplacement has been described. Post-cardiac surgery patients are usually in the ICU. Therefore, if signs of GI bleeding are present in the postoperative period, EGD should be performed for diagnostic purposes. However, rarely displaced pacemaker wire may be one of the causes of GI bleeding, which should be on the physician's radar.Figure 1.: (A) EGD showing pooled blood in stomach giving definitive evidence of upper GI bleed. (B) EGD showing pacemaker wire traversing the stomach.

Visualization of Cholesterol Crystals Liberated From a Diseased Saphenous Vein Coronary Bypass Graft

A 60-year-old man who had undergone coronary artery bypass graft surgery 16 years previously was transported to our hospital for unstable angina pectoris. Cardiac catheterization revealed that a saphenous vein graft (SVG) to the left anterior descending coronary artery was significantly stenosed ([

Sequential Saphenous Vein Coronary Bypass Grafting.

The enormous majority of previous reports focused on evaluating the safety and efficacy of sequential saphenous vein (SV) coronary bypass grafting; however, no reports to date have revealed concern regarding the impacts of the number of distal anastomoses of sequential SV grafting on graft patency after coronary artery bypass grafting (CABG). This single-center retrospective study aimed to evaluate the impacts of three versus two distal anastomoses per single SV conduit on SV graft patency after off-pump CABG, and to determine the independent risk factors for sequential SV graft failure.From January 2011 to December 2014, 1320 eligible patients were assigned to either a triple group (three distal anastomoses of sequential SV grafting, n = 758) or a double group (two distal anastomoses of sequential SV grafting, n = 562). The primary endpoint was over a 2-year follow-up SV graft failure after off-pump CABG.The triple and double group received a similar total patency rate of sequential SV conduits (86.5% versus 87.1%, P = 0.757). The number of distal anastomoses of sequential SV grafting (three versus two) was not a predictive factor for the follow-up graft failure of sequential SV conduits (HR = 0.91, 95% CI: 0.66-2.29, P = 0.137). Moreover, the two groups received a similar follow-up survival freedom from repeat revascularization (χ2 = 1.881, log-rank P = 0.170).Three versus two distal anastomoses per single SV conduit received a similar SV graft patency. The number of distal anastomoses of sequential SV grafting was not an independent risk factor for graft failure.

Antithrombotic therapy in patients receiving saphenous vein coronary artery bypass grafts: a protocol for a systematic review and network meta-analysis

IntroductionThe current evidence for the prevention of saphenous vein graft failure (SVGF) after coronary artery bypass graft (CABG) surgery consists of direct head-to-head comparison of treatments (including placebo) in randomised-controlled...

Use of Embolic Protection Devices in Peripheral Interventions.

The use of embolic protection devices (EPDs) when treating coronary saphenous vein bypass grafts, performing carotid arterial stenting and treating acute coronary syndromes is well accepted. We will review currently available devices and approaches to reduce distal embolisation, first discussing their uses in carotid interventions and then in vertebral and peripheral vascular interventions.

Effects of Aggressive Statin Therapy on Patients With Coronary Saphenous Vein Bypass Grafts: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

ObjectivesThe aim of this study was to investigate the effectiveness and safety of aggressive statin versus moderate statin therapy on patients with saphenous vein grafts (SVGs) in randomized, controlled trials (RCTs). MethodsWe searched MEDLINE (1980–June 2012), the Cochrane Controlled Trials Register, EMBASE, Science Citation Index, and PubMed (to June 2012), and found 10 relevant RCTs, including 7 substudy analyses from a Post-CABG trial, and 1 pooled analysis of the PROVE-IT TIMI 22 trial (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators) and A to Z trial. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes; phase Z of the A to Z trial. ResultsA total of 6645 of participants, ages ranging from 21 to 75 years old, were treated with coronary artery bypass graft (CABG) and were followed for 2 to 5 years. Eight studies showed that aggressive statin therapy had lower LDL-C levels and a decrease of 39% in graft atherosclerotic progression, 12% in new occlusions, and 19% in new lesions more than moderate statin therapy. Three reports indicated that aggressive statin therapy lowered the risk of repeated myocardial infarction more than moderate statin therapy for coronary revascularization (95% CI, 0.66–0.95; risk ratio [RR] = 0.80; and 95% CI, 0.66–0.85; RR = 0.75) and lowered the risk of cardiac death as well (95% CI, 0.64–1.08; RR = 0.83). Aggressive statin therapy had safety similar to that of moderate statin therapy except for a slight increase in myopathic events and aminotransferase levels. Seventy percent to 90% of patients took statin treatment as prescribed in long-term. ConclusionsCompared with moderate statin therapy, long-term aggressive statin lowered the LDL-C level significantly, further decreased the atherosclerotic progression of SVG, reduced the risks of repeated myocardial infarction and coronary revascularization after CABG, and revealed similar patient compliance and statin-related adverse effects but slightly increased myopathy events and aminotransferase levels.

Managing coronary artery vein bypass graft stump pseudoaneurysm: a novel approach

We present a case of a pseudoaneurysm of the saphenous vein graft stump, which was managed with percutaneous thrombin injection. Aneurysms of a saphenous vein coronary bypass graft are rare and aneurysms of a bypass graft stump are even rarer. To our knowledge this is the first reported case of a pseudoaneurysm of a graft stump with the use of thrombin to treat a saphenous vein graft pseudoaneurysm.

Tools & Techniques: Percutaneous intervention of saphenous vein graft lesions

© Europa Digital & Publishing 2013. All rights reserved. Background The percutaneous treatment of patients with obstructive atherosclerotic disease in coronary saphenous vein bypass grafts (SVG) remains a challenge in interventional cardiology. Patients undergoing SVG intervention are often older, and suffer significant comorbidities. Moreover, SVGs usually present a degenerated pattern of atherosclerosis, with complex, friable, thrombotic-prone lesions. SVG interventions carry a higher risk of acute complications, mainly distal embolisation, and poorer long-term outcomes, mainly restenosis, than do native coronary vessel interventions1,2. The predictors of one-month major cardiac events after SVG intervention have been explored recently3. The degree of SVG degeneration assessed by the SVG degeneration score, the estimated plaque volume, angiographic evidence of thrombus, and increasing patient age are the correlates associated with the 30-day composite outcome of death, myocardial infarction (MI) and target lesion revascularisation (TLR). Thus, an important reason for poorer outcomes of percutaneous coronary interventions (PCI) in SVGs is the embolisation of atherothrombotic debris into the native coronary circulation, often resulting in periprocedural MI or reduced antegrade flow (“no-reflow”). Strategies for addressing this distal embolisation problem include both proximal and distal protection devices, as well as adjunctive pharmacology and stenting approaches. Embolic protection devices have demonstrated value in decreasing the risk of embolisation and post-procedural myocardial enzyme elevation after SVG intervention. While stenting has definitely been proved to be superior to balloon-only angioplasty for the treatment of SVG lesions, the choice of the type of stent (bare metal stent versus drugeluting stent) is still a matter of debate. Drug-eluting stents appear promising for the successful sealing of SVG disease; however, available long-term safety and effectiveness data are conflicting and give reason for caution.

The Patency of Sequential and Individual Vein Coronary Bypass Grafts: A Systematic Review

Saphenous vein grafts continue to be the backbone of daily coronary revascularization practice, but controversy still exists about whether to use them as an individual or sequential graft. We undertook a systematic review and meta-analysis of cohort studies to compare the midterm or long-term patency of sequential vein coronary bypass grafts with those of vein grafts. A comprehensive search strategy was run in PubMed, Embase, the Cochrane Library, and the Chinese Biomedical Literature Database. Inclusion criteria were the following: (1) two cohorts of patients received sequential and single saphenous vein coronary bypass grafting, respectively; (2) prospective or retrospective cohort design; and (3) graft patency examined by angiography or ultrafast computed tomography. Two researchers independently performed the literature search, data extraction, and quality assessment. We identified 1,385 titles, reviewed 38 articles for inclusion criteria, and included 12 studies in the meta-analysis. The risk of occlusion in sequential grafts was lower (risk ratio [RR] = 0.67, 95% confidence interval [CI] 0.60 to 0.74) than that in single grafts. The risk of occlusion in side-to-side anastomoses was lower (RR = 0.52; 95% CI, 0.34 to 0.80) than that of end-to-side anastomoses for sequential vein grafts. There was no difference in occlusion between the distal end-to-side anastomoses of sequential vein grafts and those of single vein grafts (RR = 0.85; 95% CI, 0.68 to 1.06). The midterm and long-term patency of sequential vein grafts appears to be better than that of single vein grafts and the patency of side-to-side anastomoses appears to be better than that of end-to-side anastomoses for sequential vein grafts.

55 Stem cell reduces intimal thickening in experimental porcine vein grafts

Rational for the StudyLong term patency of autologous saphenous vein coronary bypass grafts is limited by neointima formation and atherosclerosis. Neointima is promoted by adventitial hypoxia. Hence we investigated the...

Letter by Doraiswamy Regarding Article, “Vascular Reactivity and Flow Characteristics of Radial Artery and Long Saphenous Vein Coronary Bypass Grafts: A 5-Year Follow-Up”

To the Editor: Webb et al described the flow response to endothelial acting agents in their study on radial artery and saphenous vein grafts.1 The superiority of radial artery over saphenous vein grafts is well supported by these blood flow changes in addition to diameter changes, which have been shown in multiple other studies. Some additional clarifications might be of great help in extrapolating the …

Response to Letters Regarding Article, “Vascular Reactivity and Flow Characteristics of Radial Artery and Long Saphenous Vein Coronary Bypass Grafts: A 5-Year Follow-Up”

Our study showed that 5 years after aortocoronary bypass graft surgery, radial artery grafts had preserved flow-mediated dilatation, whereas saphenous vein (SV) grafts had not.1 In agreement with Brugaletta et al, we feel it would be ideal to know the preexisting vasomotor response of the study grafts in all patients. Unfortunately, not all the patients who were studied at 3 months agreed to participate at 5 years.1,2 Four patients participated in Doppler studies at both follow-ups (radial artery=2 and SV=2), and we believe that the numbers are …

Letter by Brugaletta et al Regarding Article, “Vascular Reactivity and Flow Characteristics of Radial Artery and Long Saphenous Vein Coronary Bypass Grafts: A 5-Year Follow-Up”

To the Editor: We read with interest the article by Webb et al,1 demonstrating that, 5 years after coronary surgery, radial artery (RA) grafts have a preserved flow-mediated vasodilatation, whereas saphenous vein (SV) grafts have not. We agree with the authors that these results may provide insight into the more favorable patency of the RA graft over the SV graft, because the RA grafts preserved their ability to autoregulate their diameter in response to changes in myocardial flow physiology. However, some considerations about the SV graft should be highlighted. First, although the results represent a situation 5 years after the surgery, it is important to know the …

Morphological and functional 3-Tesla magnetic resonance imaging of saphenous vein coronary artery bypass grafts

Evaluation of a novel non-invasive tool for postoperative follow-up of patients postelective saphenous vein coronary artery bypass graft (CABG) was performed. Ten patients were included. Their bypass grafts supplied the right coronary artery (7), marginal branches (1), diagonal branches (2), and the circumflex artery (n=1). Each bypass was examined intraoperatively using Doppler flow measurement. Patients were examined with a 3-Tesla magnetic resonance imaging (MRI) scanner (MAGNETOM Verio, Siemens, Erlangen, Germany) within one week postsurgery using MR-angiography with an intravasal contrast agent and velocity encoded phase-contrast flow measurements. Intraoperative Doppler flow measurements revealed regular flow patterns in all vascular territories supplied. The median intraoperative flow rate was 50 ml/min with an inter-quartile range (IQR) of 42-70 ml/min. The clinical postoperative course was uneventful. MRI showed all grafts to be patent. The median postoperative flow rate was 50 ml/min (IQR: 32-65 ml/min). MRI flow rates agreed well with intraoperative Doppler flow measurements (mean difference: -2.8±20.1 ml/min). This initial study demonstrates that 3-Tesla MRI flow measurements correlated well with Doppler thus reconfirming the graft patency postCABG. Further refinement and broader application of this technique may facilitate follow-up postCABG potentially replacing empiric clinical judgment by reliable non-invasive imaging.

Coronary Artery Bypass Graft for Anomalous Right Coronary Artery

A 27-year-old man with anomalous right coronary artery (RCA) presented with ventricular fibrillatory arrest. Computed tomography angiography revealed an anomalous RCA arising from the left sinus of Valsalva with an acute angulation at the coronary takeoff and compressed interarterial segment. This patient underwent a short saphenous vein coronary artery bypass graft to the proximal RCA and recovered uneventfully. A review of the literature and discussion of the surgical management is presented.

Vascular Reactivity and Flow Characteristics of Radial Artery and Long Saphenous Vein Coronary Bypass Grafts

Radial artery (RA) aortocoronary bypass grafts anastomosed to a branch of the circumflex coronary artery have significantly better patency rates than saphenous vein (SV) grafts at 5 years, but the physiological characteristics and mechanisms involved are not clearly defined. We compared RA and SV graft vasomotor and flow responses to endothelium-dependent and -independent stimuli 5 years after surgery in a subgroup of patients enrolled in the Radial artery versus Saphenous Vein Patency (RSVP) trial. Twenty-seven patients were included in the study (RA, n=15; SV, n=12). Graft blood flow was calculated from flow velocity, measured by intracoronary Doppler, and luminal diameter, measured by quantitative coronary angiography, before and after intragraft infusions of adenosine, acetylcholine, and isosorbide dinitrate. At rest, RA luminal diameters were significantly smaller than SV luminal diameters (P=0.029), blood flow velocity was greater in RA than SV (P=0.008), and volume blood flows were similar. RA but not SV dilated in response to adenosine and isosorbide dinitrate (all P<0.05, RA versus SV, percent change from baseline), and there were no significant differences in the diameter responses to acetylcholine. Volume blood flow responses to adenosine, acetylcholine, and isosorbide dinitrate were comparable. Five years after surgery, RA coronary bypass conduits grafted to a single coronary territory demonstrated preserved flow-mediated vasodilatation, whereas SV grafts did not. Our results may provide insight into the more favorable patency of RA grafts over SV grafts. http://www.clinicaltrials.gov. Unique identifier: NCT00139399.

The impact of sequential versus single anastomoses on flow characteristics and mid-term patency of saphenous vein grafts in coronary bypass grafting

To assess the influence of bypass grafting technique on the flow characteristics and mid-term patency of saphenous vein coronary bypass grafts. In the present study, 309 patients who underwent either sequential (group A, N = 84 grafts) or individual (group B, N = 244 grafts) saphenous vein coronary bypass grafting between February 2002 and September 2007 were investigated. Individual bypassing only was performed in 212 patients, and sequential bypassing only was performed in 78 patients. The remaining 19 patients received both. A total of 436 distal anastomoses were performed with 328 saphenous vein grafts. The intraoperative flow characteristics and the graft patency were assessed with the transit time flow meter and serial multi-detector computed tomography coronary angiograms, respectively. Group A showed a higher mean flow compared with group B at 49.4 ± 27.4 mL/min versus 37.1 ± 20.1 mL/min, respectively (P = .001). The mean flow increased linearly as the number of anastomoses increased per graft (P < .001). Graft patency at 3 years was 93.3% ± 3.4% in group A and 86.5% ± 3.1% in group B (P = .048). After adjustment for baseline characteristics, group A showed a tendency for superior mid-term patency than group B (hazard ratio 0.362; 95% confidence interval, 0.129-1.017; P = .0538). Sequential bypass grafts were associated with higher mean flows and superior mid-term patency compared with individual grafts. These findings suggest the more favorable results of sequential bypass grafting to be attributed to the enhanced flow hemodynamics.

Thermal coronary angiography for intraoperative patency control of arterial and saphenous vein coronary artery bypass grafts: results in 370 patients.

Early graft failure is often associated with technical failures and is therefore potentially avoidable. We used thermal coronary angiography (TCA) for intraoperative graft patency control in 370 patients undergoing routine coronary artery bypass graft surgery to determine whether consequent intraoperative bypass graft control may result in improved patency rates. The temperature differences generated in between the myocardium and the grafts by injecting cold cardioplegic solution into the proximal end of a vein graft or by warmer blood running through an internal thoracic artery (ITA) graft were detected using three different infrared camera systems. The resulting "heat pictures" were evaluated for anastomotic patency and to outline graft anatomy. A total of 693 vein grafts were visualized. In 9.4% TCA failed to produce usable images. In the remaining 628 grafts, TCA revealed intraoperative patency in 98.8%. Out of 370 ITA grafts, only 14 could not be sufficiently visualized by TCA. Nineteen ITA occlusions (5.3%) were found: 5 intimal flaps; 11 suture imposed strictures; and 3 proximal ITA occlusions. All occluded grafts were subsequently revised or replaced. All sequential ITA as well as 15 right ITA grafts proved to have patent anastomoses. Using TCA an early graft dysfunction rate of 1% for vein grafts and 5.3% for ITA grafts could be demonstrated. Most occlusions were due to technical mistakes at the distal anastomosis. TCA outlines grafts and the attached coronaries by temperature differences without the need for a contrast agent. There is no interference with the surgical procedure. It is an ideal, noninvasive method to immediately document the success or failure of myocardial revascularization.

Letter by Nežić et al Regarding Article, “The Impact of Diabetic Status on Coronary Artery Bypass Graft Patency: Insights From the Radial Artery Patency Study”

HomeCirculationVol. 119, No. 22Letter by Nežić et al Regarding Article, “The Impact of Diabetic Status on Coronary Artery Bypass Graft Patency: Insights From the Radial Artery Patency Study” Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBLetter by Nežić et al Regarding Article, “The Impact of Diabetic Status on Coronary Artery Bypass Graft Patency: Insights From the Radial Artery Patency Study” Duško Nežić, MD, PhD, FETCS, Aleksandar Knežević, MD, BcS, Miomir Jović, MD, PhD and Petar Vuković, MD, BcS Duško NežićDuško Nežić “Dedinje” Cardiovascular Institute, Belgrade, Serbia Search for more papers by this author , Aleksandar KneževićAleksandar Knežević “Dedinje” Cardiovascular Institute, Belgrade, Serbia Search for more papers by this author , Miomir JovićMiomir Jović “Dedinje” Cardiovascular Institute, Belgrade, Serbia Search for more papers by this author and Petar VukovićPetar Vuković “Dedinje” Cardiovascular Institute, Belgrade, Serbia Search for more papers by this author Originally published9 Jun 2009https://doi.org/10.1161/CIRCULATIONAHA.108.832063Circulation. 2009;119:e559To the Editor:We read with great interest the article by Singh and associates1 that was recently published in Circulation. We respect all subsequent analysis arising from an excellent, prospective, randomized basic study presented by Desai and colleagues2 a few years ago that compared the angiographic patency of radial artery (RA) grafts with that of saphenous vein (SV) grafts 1 year after surgery. Although that study demonstrated significantly better angiographic patency of RA conduits compared with SV grafts (occlusion rate of 8.2% for RA conduits versus 13.6% for SV conduits), the existence of a string sign was assigned to 7% of RA grafts and to only 0.9% of SV grafts. Subsequent analysis of those data3 showed that 48.4% (15 out of 31) of the RA conduits with a string sign presented with thrombolysis in myocardial infarction (TIMI) 1 flow. A significantly higher rate of postoperative angina has been registered in patients whose RA conduits were found to have a string sign and TIMI 1 flow.3The primary end point of the study by Singh et al1 was to determine overall study graft failure, and the secondary objective was to compare graft failure of the study RA conduits versus the study SV conduits within nondiabetic and diabetic patients. All RA conduits with a string sign were considered to be patent. In our opinion, if we are discussing the failure and occlusion of study grafts, RA grafts with an angiographic string sign should be included in the category of failed conduits (at least those with TIMI 1 flow because TIMI 1 flow has been defined as some penetration of contrast material beyond the point of obstruction but without perfusion of the distal coronary bed4). Although only the perioperative use of α-adrenergic agonists and target vessels stenosis <90% were pointed out as significant factors for a string sign3 appearance of RA conduits, we assume that RA conduits with a string sign and TIMI 1 flow were similarly distributed among diabetic and nondiabetic patients. Some of the authors’ conclusions are based on the border level of statistical significance (ie, RA protectiveness against graft failure compared with SV grafting in both diabetic and nondiabetic cohorts). It is possible that, with the inclusion of all RA conduits that have definitely failed (36 occluded, 15 with a string sign and TIMI 1 flow), the findings of the study would no longer be statistically significant.DisclosuresNone. References 1 Singh S, Desai N, Petroff S, Deb S, Cohen E, Radhakrishnan S, Schwartz L, Dubbin J, Fremes S, for the Radial Artery Patency Study Investigators. The impact of diabetic status on coronary artery bypass graft patency: insights from the radial artery patency study. Circulation. 2008; 118: S-222–S-225.Google Scholar2 Desai N, Cohen E, Naylor D, Fremes E, for the Radial Artery Patency Study Investigators. A randomized comparison of radial artery and saphenous vein coronary bypass grafts. N Engl J Med. 2004; 351: 2302–2309.CrossrefMedlineGoogle Scholar3 Miwa S, Desai N, Koyama T, Chan E, Cohen E, Fremes S, from the Radial Artery Patency Study Investigators. Radial artery angiographic string sign: clinical consequences and the role of pharmacologic therapy. Ann Thorac Surg. 2006; 81: 112–119.CrossrefMedlineGoogle Scholar4 Appleby MA, Michaels AD, Chen M, Gibson CM. Importance of the TIMI frame count: implications for future trials. Curr Control Trials Cardiovasc Med. 2000; 1: 31–34.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails June 9, 2009Vol 119, Issue 22 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.108.832063PMID: 19506121 Originally publishedJune 9, 2009 PDF download Advertisement

Biomechanical stress induces novel arterial intima-enriched genes: implications for vascular adaptation to stress

The arterial vasculature is subjected to considerably greater biomechanical stress than the venous circulation. This is reflected in the difference in morphology between large arteries and veins, however little is known about the molecular differences that arise as a consequence of biomechanical stress. Previously, we identified a group of arterial intima-enriched (AIE) genes: sciellin, periplakin, SPRR3, envoplakin, galectin 7, and plakoglobin that are functionally related in that they contribute to the stress properties of stratified epithelium. We sought to test our hypothesis that these genes were regulated by biomechanical stress in vascular smooth muscle cells (VSMCs). Immunofluorescence was employed to determine the expression of the AIE genes in saphenous vein coronary artery bypass grafts. Furthermore, we used a model of cyclic stress to determine if the AIE genes were regulated by biomechanical stress in VSMCs in vitro. Sciellin and periplakin were upregulated in saphenous vein coronary artery bypass grafts after arterialization, but were absent in non-arterialized saphenous veins. Sciellin, SPRR3, and periplakin transcripts were all upregulated (4.67-, 4.95-, 2.77-fold, respectively) by prolonged exposure to cyclic strain (24-72 h), but not at earlier time points. These findings suggest a novel role for several human AIE genes in the VSMC response to arterialization and extended cyclic strain. Biomechanical stress has long been implicated in vascular pathologies. We report the novel finding of a group of genes, previously studied in stratified epithelium, that were regulated by prolonged cyclic stress in vascular smooth muscle cells. This may have important implications to vascular disease.