Original articleAdult cardiacA Randomized Trial of External Stenting for Saphenous Vein Grafts in Coronary Artery Bypass Grafting
Section snippets
Study Design and Population
The VEST trial, conducted from October 2011 to September 2013, was a prospective, multicenter, randomized and self-controlled study. The study was approved by a UK Research Ethics Committee, and all subjects gave informed consent. Patients were eligible if they were scheduled for on-pump multivessel CABG including a left internal mammary artery to the left anterior descending coronary artery and SVGs to right and circumflex territories. Eligibility required a target vessel diameter of 1.5 mm or
Patients, Procedure, and Follow-Up
Thirty-five patients were enrolled, and 30 were randomly assigned to the VEST trial between October 2011 and September 2012. Demographic characteristics for the randomized patients are shown in Table 1. During surgery, 4 patients were deemed ineligible due either to inadequate vein quality or target coronary artery calcification, and 1 patient was not randomized for administrative reasons. Thirty grafts, 1 per patient, were successfully stented with the study device and compared with 39
Comment
The key finding in the current study is that a mechanical external stent has the potential to reduce the process of diffuse intimal hyperplasia in SVG 1 year after CABG. External stenting of SVG resulted in a statistically significant reduction of this area by approximately 15% (p = 0.04). Several studies have previously reported comparable plaque areas in SVG 12 months after implantation 9, 22, and to date, only statins and beta-blockers have been shown to reduce the process [10].
A particular
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