VENOUS EXTERNAL SUPPORT (VEST) ENHANCED CABG: MID TERM CLINICAL FOLLOW UP OF A MULTICENTRIC STUDY

Objectives: The main objective of this multicentric study is to evaluate the mid-term clinical outcome in coronary artery bypass grafting (CABG) patients, and specifically need for repeat revascularizations associated with VEST supported saphenous vein graft (SVG), compared with unsupported SVG. Methods and results: 397 patients underwent CABG in a multicentric real-world setting, with or without concomitant procedures, with at least one SVG supported with an external stent. Patients were followed for major adverse cardiac and cerebral events (MACCE) for a mean duration of 30(1-101) months. Overall, 469 external stents were implanted accounting for 71.7% of all 654 vein grafts. Revascularization rates in territories which were grafted with non- stented SVGs were significantly higher (4.32%) than the rates in territories grafted with an externally stented SVG (1.28%) during the index procedure (p=0.015). Freedom from MACCE at 1,3 and 5 years was 95.1% (SE 0.011), 85.4% (SE 0.021), and 82.4% (SE 0.030) respectively. Conclusions: VEST-enhanced CABG is safe and feasible in real world routine practice which includes on and off pump CABG, sequential grafting, and concomitant valve surgery. Mid term clinical follow up suggests that VEST enhanced CABG is associated with low revascularization rates, and these interventional procedures are mostly to non-VESted SVG territories.