Device profile of the VEST for external support of SVG Coronary artery bypass grafting: historical development, current status, and future directions

Introduction : A search for strategies to address saphenous vein graft (SVG) failure–the main factor limiting the long-term success of coronary bypass grafting–has led to trialing of external stenting technologies. Areas covered : The manuscript covers historical development and current status of external scaffolding for the treatment of SVG intimal hyperplasia. Comprehensive literature review and personal communication with VGS leadership, the developer of the VEST device, served as the sources. Expert opinion : If the external scaffolding concept proves to be successful in mitigating the intimal hyperplasia inherent to arterialized saphenous vein conduits, it could have a dramatic impact on the recurrence of anginal symptoms, the need for repeat revascularization, and the incidence of myocardial infarction following CABG surgery. These laudable sequelae could ultimately convey significant public health repercussions by reducing healthcare resource use and improving the long-term survival and quality of life of CABG recipients.