Initial Experience with Multiple VEST Implants for Supporting Vein Grafts in CABG Surgery

Background:
VEST (VGS, Tel Aviv, Israel) is an external support for saphenous vein grafts (SVG) designed to provide mechanical support for the reduction of SVG diffuse intimal hyperplasia and lumen irregularities.

Previous randomized controlled experience with this technology demonstrated statistically significant reduction in vein grafts disease and improved lumen uniformity at 1 and 5 years post implantation.

Experience included single vein graft supported by VEST and additional (at least one) vein graft was served as control.

To date no data was published on the use of the device for multiple vein grafts within the same patient.

Methods:
This initial experience is planned for 60 patients undergoing CABG with multiple SV grafts.

All SVGs will be supported by the VEST device. All patients will be followed up at 6 weeks post CABG and the patency of the SVGs will be tested using coronary CT angiography (CTA).

The primary objectives are to evaluate device usability and technical success (early patency rates) and to further evaluate the clinical outcome and vein grafts patency at 1 and 5 years post implantation using angiography.

Results:
60 patients were treated with an average of 3 saphenous vein grafts supported with VEST in our center. All implantations have been successful and with no clinical adverse events. There were no death and no perioperative myocardial infarction.

Conclusions:
Our early clinical experience with the novel VEST external support technology for saphenous vein grafts during CABG was found to be safe and easy to apply. Operative time, total and cross clamp time, was not significantly increased.

More patients and future coronary CT angiography will supply efficacy data. This may confirm the 1 and 5 years positive efficacy results that were recently reported from the Oxford trial.