Tubular Nitinol Knit Meshes for External Reinforcement of Saphenous Vein Grafts: A Numerical Design Study

Author(s):  
Thomas Franz ◽  
Helena van der Merwe ◽  
Peter Zilla ◽  
Deon Bezuidenhout ◽  
B. Daya Reddy

The difference in mechanical properties between grafts and host arteries is a complicating factor for vascular bypass surgery and can cause patho-physiological problems after implantation [1–7]. Diffuse and focal intimal hyperplasia, one of the key factors of vein graft failure, has been attributed to over-distension and diametric irregularities of the veins when exposed to the arterial circulation [8]. The external reinforcement of saphenous vein grafts with open-mesh knitted Nitinol structures is suggested to prevent over-distension, smooth the luminal diameter, and address the mismatch in mechanical properties of vein graft and host vessel. The objectives of this work were: 1) development of Finite Element (FE) models of knitted Nitinol structures to assess mechanical behaviour and structural properties, e.g. vascular compliance, and 2) proof of feasibility of the FE method developed for structural design optimisation of the Nitinol mesh.

2013 ◽  
Vol 168 (3) ◽  
pp. 2468-2473 ◽  
Author(s):  
Abdul-rahman R. Abdel-karim ◽  
Monica Da Silva ◽  
Christopher Lichtenwalter ◽  
James A. de Lemos ◽  
Owen Obel ◽  
...  

2010 ◽  
Vol 76 (2) ◽  
pp. 263-269 ◽  
Author(s):  
Neeraj Badhey ◽  
Christopher Lichtenwalter ◽  
James A. de Lemos ◽  
Michele Roesle ◽  
Owen Obel ◽  
...  

Author(s):  
Ninos Samano ◽  
Domingos Souza

After almost 30 years since the first harvesting of the saphenous vein graft with a pedicle of surrounding tissue (no-touch technique), there is no doubt that this method is superior to the conventional technique in which a denuded vein is harvested. In summary, the no-touch harvesting technique decreases risk of graft spasm and the requirement for manual dilatation, limiting endothelial cell loss and long-term damage. The preservation of the vasa vasorum allows retrograde blood flow from the graft lumen, thereby decreasing transmural ischaemic damage. This also preserves endothelial nitric oxide synthase, known to decrease intimal hyperplasia, atherosclerosis, and long-term graft failure. Furthermore, the perivascular tissue acts as a natural external stent reducing the neointimal and medial thickening of the vein graft and preventing it from kinking, which is especially vital for sequential grafts. Finally, target vessel size, quality, and degree of stenosis have little effect on the patency rates of no-touch saphenous vein grafts, in contrast to arterial grafts.


2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Carmelo J. Panetta ◽  
Williaim Schneider ◽  
Max A. Boller

Aneurysms of saphenous vein grafts are rare but can result in complications such as myocardial infarction or death. Percutaneous treatment has included a variety of approaches, including covered stents. Long aneurysms in saphenous vein grafts pose an additional challenge due to the lack of coronary covered stents with sufficient length. We present successful treatment of a long saphenous vein graft aneurysm with use of peripheral covered stents over two coronary guidewires, a 55-centimeter 8-French sheath and no guide catheter.


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