Effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass
<p><strong>OBJECTIVES</strong></p> <p>In a post hoc analysis of the VEST III trial, we investigated the effect of the harvesting technique on saphenous vein graft (SVG) patency and disease progression after coronary artery bypass grafting.</p> <p><strong...
| Hlavní autoři: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Médium: | Journal article |
| Jazyk: | English |
| Vydáno: |
Oxford University Press
2022
|
| _version_ | 1826308114753781760 |
|---|---|
| author | Sandner, SE Donovan, TJ Edelstein, S Puskas, JD Angleitner, P Krasopoulos, G Channon, K Gehrig, T Rajakaruna, C Ladyshenskij, L De Silva, R Bonaros, N Bolotin, G Jacobs, S Thielmann, M Choi, Y-H Ohri, S Lipey, A Friedrich, I Taggart, DP |
| author_facet | Sandner, SE Donovan, TJ Edelstein, S Puskas, JD Angleitner, P Krasopoulos, G Channon, K Gehrig, T Rajakaruna, C Ladyshenskij, L De Silva, R Bonaros, N Bolotin, G Jacobs, S Thielmann, M Choi, Y-H Ohri, S Lipey, A Friedrich, I Taggart, DP |
| author_sort | Sandner, SE |
| collection | OXFORD |
| description | <p><strong>OBJECTIVES</strong></p>
<p>In a post hoc analysis of the VEST III trial, we investigated the effect of the harvesting technique on saphenous vein graft (SVG) patency and disease progression after coronary artery bypass grafting.</p>
<p><strong>METHODS</strong></p>
<p>Angiographic outcomes were assessed in 183 patients undergoing open (126 patients, 252 SVG) or endoscopic harvesting (57 patients, 114 SVG). Overall SVG patency was assessed by computed tomography angiography at 6 months and by coronary angiography at 2 years. Fitzgibbon patency (FP I, II and III) and intimal hyperplasia (IH) in a patient subset were assessed by coronary angiography and intravascular ultrasound, respectively, at 2 years.</p>
<p><strong>RESULTS</strong></p>
<p>Baseline characteristics were similar between patients who underwent open and those who underwent endoscopic harvesting. Open compared with endoscopic harvesting was associated with higher overall SVG patency rates at 6 months (92.9% vs 80.4%, P = 0.04) and 2 years (90.8% vs 73.9%, P = 0.01), improved FP I, II and III rates (65.2% vs 49.2%; 25.3% vs 45.9%, and 9.5% vs 4.9%, respectively; odds ratio 2.81, P = 0.09) and reduced IH area (-31.8%; P = 0.04) and thickness (-28.9%; P = 0.04). External stenting was associated with improved FP I, II and III rates (odds ratio 2.84, P = 0.01), reduced IH area (-19.5%; P < 0.001) and thickness (-25.0%; P < 0.001) in the open-harvest group and reduced IH area (-12.7%; P = 0.01) and thickness (-9.5%; P = 0.21) in the endoscopic-harvest group.</p>
<p><strong>CONCLUSIONS</strong></p>
<p>A post-hoc analysis of the VEST III trial showed that open harvesting is associated with improved overall SVG patency and reduced IH. External stenting reduces SVG disease progression, particularly with open harvesting.</p>
|
| first_indexed | 2024-03-07T07:13:10Z |
| format | Journal article |
| id | oxford-uuid:01b71f80-fbb5-4029-a73c-fa9dd4a59b37 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:13:10Z |
| publishDate | 2022 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:01b71f80-fbb5-4029-a73c-fa9dd4a59b372022-07-27T09:30:17ZEffects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypassJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:01b71f80-fbb5-4029-a73c-fa9dd4a59b37EnglishSymplectic ElementsOxford University Press2022Sandner, SEDonovan, TJEdelstein, SPuskas, JDAngleitner, PKrasopoulos, GChannon, KGehrig, TRajakaruna, CLadyshenskij, LDe Silva, RBonaros, NBolotin, GJacobs, SThielmann, MChoi, Y-HOhri, SLipey, AFriedrich, ITaggart, DP<p><strong>OBJECTIVES</strong></p> <p>In a post hoc analysis of the VEST III trial, we investigated the effect of the harvesting technique on saphenous vein graft (SVG) patency and disease progression after coronary artery bypass grafting.</p> <p><strong>METHODS</strong></p> <p>Angiographic outcomes were assessed in 183 patients undergoing open (126 patients, 252 SVG) or endoscopic harvesting (57 patients, 114 SVG). Overall SVG patency was assessed by computed tomography angiography at 6 months and by coronary angiography at 2 years. Fitzgibbon patency (FP I, II and III) and intimal hyperplasia (IH) in a patient subset were assessed by coronary angiography and intravascular ultrasound, respectively, at 2 years.</p> <p><strong>RESULTS</strong></p> <p>Baseline characteristics were similar between patients who underwent open and those who underwent endoscopic harvesting. Open compared with endoscopic harvesting was associated with higher overall SVG patency rates at 6 months (92.9% vs 80.4%, P = 0.04) and 2 years (90.8% vs 73.9%, P = 0.01), improved FP I, II and III rates (65.2% vs 49.2%; 25.3% vs 45.9%, and 9.5% vs 4.9%, respectively; odds ratio 2.81, P = 0.09) and reduced IH area (-31.8%; P = 0.04) and thickness (-28.9%; P = 0.04). External stenting was associated with improved FP I, II and III rates (odds ratio 2.84, P = 0.01), reduced IH area (-19.5%; P < 0.001) and thickness (-25.0%; P < 0.001) in the open-harvest group and reduced IH area (-12.7%; P = 0.01) and thickness (-9.5%; P = 0.21) in the endoscopic-harvest group.</p> <p><strong>CONCLUSIONS</strong></p> <p>A post-hoc analysis of the VEST III trial showed that open harvesting is associated with improved overall SVG patency and reduced IH. External stenting reduces SVG disease progression, particularly with open harvesting.</p> |
| spellingShingle | Sandner, SE Donovan, TJ Edelstein, S Puskas, JD Angleitner, P Krasopoulos, G Channon, K Gehrig, T Rajakaruna, C Ladyshenskij, L De Silva, R Bonaros, N Bolotin, G Jacobs, S Thielmann, M Choi, Y-H Ohri, S Lipey, A Friedrich, I Taggart, DP Effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass |
| title | Effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass |
| title_full | Effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass |
| title_fullStr | Effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass |
| title_full_unstemmed | Effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass |
| title_short | Effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass |
| title_sort | effects of the harvesting technique and external stenting on progression of vein graft disease 2 years after coronary artery bypass |
| work_keys_str_mv | AT sandnerse effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT donovantj effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT edelsteins effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT puskasjd effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT angleitnerp effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT krasopoulosg effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT channonk effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT gehrigt effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT rajakarunac effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT ladyshenskijl effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT desilvar effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT bonarosn effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT boloting effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT jacobss effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT thielmannm effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT choiyh effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT ohris effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT lipeya effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT friedrichi effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass AT taggartdp effectsoftheharvestingtechniqueandexternalstentingonprogressionofveingraftdisease2yearsaftercoronaryarterybypass |