Trial reportThe Journal of thoracic and cardiovascular surgery2024
Intimal hyperplasia, saphenous vein graft disease, and clinical outcomes: Insights from the CTSN VEST randomized trial.
Trial report in The Journal of thoracic and cardiovascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- No-touch versus conventional vein in coronary artery bypass grafting: three year follow-up of multicentre randomised PATENCY trial.BMJ (Clinical research ed.) · 2025Trial
- Valve-sparing root replacement with short saphenous vein interposition for left coronary artery reconstruction in redo type A aortic dissection: a case report.Journal of surgical case reports · 2026Article
- Rolled amniotic membrane for practical vascular graft development: a scoping review.Human cell · 2026Article
- Propensity-matched analysis of the impact of saphenous vein graft external stenting on clinical outcomes in coronary bypass surgery: The RESTART study.JTCVS open · 2025Article
- Venous external support enhanced coronary artery bypass grafting: a multicentric cohort experience.Journal of cardiothoracic surgery · 2025Article
- Comparison of Fractional Flow Reserve and Myocardial Perfusion Imaging in Saphenous Vein Grafts.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Article
- Saphenous vein graft and nitric oxide: strategies to prevent graft failure and enhance patency in coronary artery bypass grafting.Frontiers in cardiovascular medicine · 2025Review
- Saphenous Vein Coronary Artery Bypass Grafts: Why Invest in VEST?Current vascular pharmacology · 2025Article
- Phenotypic switching of vascular smooth muscle cells: a central mechanism in vein graft intimal hyperplasia.Frontiers in cardiovascular medicine · 2025Review
- Techniques and Technologies to Improve Vein Graft Patency in Coronary Surgery.Medical sciences (Basel, Switzerland) · 2024Review
- External Stenting for Saphenous Vein Grafts in Coronary Surgery: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Article
- Oscillatory shear stress promotes vein graft intimal hyperplasiaFrontiers in surgery · 2023Article
Corrections and comments
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Authors and funding
28 authors at 17 institutions in 2 countries.
Funding
Abstract
backgroundDiffuse intimal hyperplasia and graft irregularity adversely affect the long-term patency of saphenous vein grafts (SVGs) and clinical outcomes of patients undergoing coronary artery bypass grafting (CABG). The VEST trial evaluated the efficacy of external graft support in limiting the development of intimal hyperplasia (IH) at 1 year postsurgery. In the present secondary analysis, we explored the associations between graft disease and IH and clinical events. We also examined risk factors for early graft occlusion.
methodsVEST is a within-patient randomized, multicenter trial that enrolled 224 patients with multivessel coronary disease undergoing CABG surgery, of whom 203 were evaluated by 1 year postsurgery. Intimal hyperplasia, lumen uniformity, graft stenosis, and graft perfusion were measured by intravascular ultrasound and angiography. Major cardiac and cerebrovascular events (MACCE; including death, myocardial infarction, stroke, and revascularization) were recorded over a median follow-up of 3 years.
resultsWorse lumen uniformity, greater stenosis, and worse graft perfusion were associated with higher IH values and an increased incidence of clinical events. Consistent with previous findings, we identified endoscopic vein harvesting, female sex, and transit time flow measurement of pulsatility index and flow as risk factors for SVG occlusion during the first year postsurgery.
conclusionsIn this secondary analysis of the VEST trial, we observed an association between intimal hyperplasia area and clinical measures of SVG disease at 1 year postsurgery. More severe SVG disease and larger areas of IH were associated with a higher incidence of 3-year MACCE. Ongoing follow-up to 5 years will further elucidate the impact of SVG disease on long-term clinical outcomes of CABG.
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