Short-term assessment of radial artery grafts with multidetector computed tomography
En Qiao1, Yuetang Wang1, Jun Yu1
1Structural Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
Insights
The radial artery (RA) shows good short-term patency in coronary artery bypass grafting (CABG). Multidetector computed tomography (MDCT) effectively visualizes RA graft patency, suggesting its utility in CABG assessments.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Vascular Grafting
Background:
- Radial artery (RA) use in coronary artery bypass grafting (CABG) is underutilized despite guideline recommendations.
- Multidetector computed tomography (MDCT) is a valuable tool for assessing CABG graft patency, offering a safer alternative to invasive angiography.
- This study evaluates the short-term outcomes of RA grafts in CABG using MDCT.
Purpose of the Study:
- To assess the short-term patency rates of radial artery (RA) grafts used in coronary artery bypass grafting (CABG).
- To evaluate the efficacy of multidetector computed tomography (MDCT) in visualizing and assessing RA graft patency.
- To compare the patency of RA grafts with other commonly used grafts in CABG.
Main Methods:
- A cohort of 41 patients undergoing elective CABG with RA grafts between 2017-2018 was studied.
- Multidetector computed tomography (MDCT) was performed for follow-up evaluation of graft patency.
- Target vessels for RA grafts were non-left anterior descending coronary arteries with >70% stenosis.
Main Results:
- A total of 150 grafts were assessed by MDCT at a mean follow-up of 8.9 months.
- MDCT provided clear visualization of graft structure and patency, even in complex revascularizations.
- Short-term graft patency rates were: Left Internal Mammary Artery 92.9%, Radial Artery 84.4%, and Saphenous Vein Graft 81.1%.
Conclusions:
- Radial artery grafts demonstrate favorable short-term patency in CABG.
- MDCT is highly effective for visualizing CABG grafts, including RA grafts.
- RA grafts may have improved patency when anastomosed to the left coronary artery system compared to the right.
Background:
The clinical use of the radial artery (RA) in coronary artery bypass grafting (CABG) is still limited worldwide, although it has been recommended by several guidelines. Multidetector computed tomography (MDCT) is widely used to evaluate graft patency, as invasive coronary angiography could cause potentially serious risks including bleeding, dissection and stroke. This study aims to report the short-term results of the RA in CABG with MDCT.
Methods:
The study population consists of 41 consecutive patients undergoing elective CABG with the RA graft between 2017 to 2018, with MDCT performed to evaluate graft patency during follow-up, and target vessels for the RA were non-left anterior descending coronary arteries with > 70% stenosis.
Results:
A total of 150 grafts were assessed by MDCT during follow-up (mean, 8.9 ± 5.1 months). MDCT could clearly show the structure and patency of grafts, even for complex coronary artery revascularization. Graft patency of the left internal mammary artery was 92.9% (39/42), with the RA patency of 84.4% (38/45) and the patency of the saphenous vein graft of 81.1% (30/37). And the RA anastomosed to the left coronary artery system might have better patency than the RA anastomosed to the right coronary artery system (25/29, 86.2% vs 13/16, 81.3%, p = 0.686).
Conclusions:
The short-term patency rate of RA grafts is good, and the RA might be associated with better patency when anastomosed to the left but not the right coronary artery. MDCT could provide excellent visualization of grafts in CABG.
More Related Videos
08:36Multi-Tracer Studies of Brain Oxygen and Glucose Metabolism Using a Time-of-Flight Positron Emission Tomography-Computed Tomography Scanner
Published on: June 7, 2024
13:16Computed Tomography and Optical Imaging of Osteogenesis-angiogenesis Coupling to Assess Integration of Cranial Bone Autografts and Allografts
Published on: December 22, 2015
Related Concept Videos
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:28Imaging Studies for Cardiovascular System V: CT