Summary

Summary

  • The technology described in this briefing is DuraGraft. It is a preservation solution used during operations for storing harvested blood vessels that will be used in coronary artery bypass graft (CABG) surgery.

  • The innovative aspects are that it is the only CE-marked ionically and pH-balanced preservation solution for vascular grafts. It contains antioxidants that aim to prevent ischaemic damage to the vascular graft and associated endothelium.

  • The intended place in therapy would be in people with coronary artery disease who are having CABG surgery.

  • The main points from the evidence summarised in this briefing are from 2 published studies involving a total of 2,555 people having CABG. These suggest DuraGraft is likely to be associated with a lower risk of developing complications such as intimal hyperplasia after CABG compared with grafts stored in saline solution. However, the studies may be open to bias from allocation concealment and patient selection.

  • Key uncertainties around the evidence are that the study results may not be generalisable to the NHS if the population having CABG differs between countries. The evidence is limited in quality and quantity and there is no evidence of the longer-term effects of DuraGraft use in the context of follow-up in a randomised controlled trial.

  • The cost of DuraGraft is £630 per patient (including VAT). The resource impact is that DuraGraft increases costs compared with standard CABG using saline or blood solutions. This could be offset if it results in a reduction in the rates of CABG complications and repeat revascularisation, but there is very limited evidence to support this at present.