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Multimodality imaging evaluation of saphenous vein graft peri-stent contrast staining enlargement

Naoki Shibata1,2, Tsuyoshi Sugiura3, Akihito Tanaka4

  • 1Ichinomiya Municipal Hospital, Ichinomiya, Japan. masa5ne0088@yahoo.co.jp.

The International Journal of Cardiovascular Imaging
|July 21, 2020
PubMed

Insights

Takayasu arteritis patients undergoing coronary artery bypass grafting (CABG) with saphenous vein grafts (SVG) may face complications. Stenting an occluded SVG led to malapposition and contrast staining, indicating graft issues.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Inflammation

Background:

  • Takayasu arteritis is a large vessel vasculitis affecting the aorta and its branches.
  • Coronary artery bypass grafting (CABG) is a treatment option for coronary artery involvement in Takayasu arteritis.
  • Saphenous vein grafts (SVG) are commonly used conduits for CABG.

Observation:

  • A patient with Takayasu arteritis developed ventricular fibrillation secondary to total occlusion of an SVG after CABG.
  • A drug-eluting stent was deployed in the occluded SVG.
  • Follow-up coronary angiography revealed extensive peri-stent contrast staining.

Findings:

  • Coronary computed tomography angiography demonstrated contrast extravasation around the SVG.
  • Intravascular ultrasound identified worsening stent malapposition.
  • Significant positive remodeling of the SVG around the stent was observed.

Implications:

  • This case highlights potential complications of stenting in SVG occlusions within the context of Takayasu arteritis.
  • Advanced imaging modalities are crucial for diagnosing graft complications.
  • Understanding SVG remodeling and stent behavior in vasculitic patients is essential for optimizing treatment strategies.

Keywords:
Multimodality imagingPeri-stent contrast stainingSaphenous vein graft

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