Stents covered by autologous venous grafts: Feasibility and immediate and long-term results

Background Previous experimental studies with a new covered stent, the auto logous venous graft-covered stent (AVGCS), have shown favorable results. Th e aim of this study was to evaluate the feasibility and safety of this new technique in human coronary arteries and to compare the long-term outcome w ith uncovered stents. Methods and Results A venous graft was removed from an upper limb. A conven tional stent then was covered by the venous graft. Fifty-eight AVGCS were i mplanted in 56 patients, including 16 patients with acute coronary syndrome s (ACS). Additionally, in 114 patients, 138 uncovered stents were implanted , serving as a control group, including 38 patients with ACS, The procedure was successful in all patients. Stent thrombosis was observed in 3 patient s in the control group and in 1 patient with an AVGCS. There was a trend fo r the minimal luminal diameter to be greater in the AVGCS group at follow-u p (P = .07), and statistical significance was observed in patients with ACS (P < .01). The target vessel revascularization and the restenosis rates we re similar between the 2 groups. In patients with ACS, the restenosis rate was less (P < .04) and there was a trend for target vessel revascularizatio n to be less in covered stents (P = .09). The event-free survival rate at 4 years was 85% in the AVGCS group versus 81% in the control group (P = not significant); in ACS it was 94% versus 78%, respectively (P = not significa nt). Stents covered by thicker venous grafts were associated with improved clinical outcome. Conclusions stents covered by autologous venous grafts may be safely prepar ed without complications. This technique may prove to be a useful means, es pecially in patients with ACS.