Graft Patency Assessment with CCTA Using a Comprehensive Singlebranch Bridging Score

Area of Science:

• Cardiology
• Radiology
• Vascular Surgery

Background:

• Coronary artery bypass grafting (CABG) is a critical intervention for severe coronary artery disease.
• Assessing pre-operative risk factors for graft patency is essential for optimizing surgical outcomes.
• Coronary computed tomography angiography (CCTA) offers detailed visualization of coronary anatomy and atherosclerosis.

Purpose of the Study:

• To evaluate the prognostic significance of the comprehensive single-branch targeted atherosclerotic risk score (CSBS) derived from CCTA.
• To determine if CSBS can predict graft failure in patients prior to undergoing CABG.
• To establish CCTA-based risk stratification for improved CABG patient management.

Main Methods:

• Retrospective analysis of 88 patients undergoing off-pump CABG with pre-operative CCTA.
• Graft failure defined by absence of follow-up CCTA or coronary angiography.
• Statistical analysis using Kaplan-Meier and Cox regression models to assess CSBS predictive value.

Main Results:

• A total of 203 grafts were analyzed, with a 14.8% occlusion rate.
• No significant difference in graft occlusion was observed across targeted vessel groups.
• Cox proportional hazard analysis identified a CSBS < 20 as a significant predictor of graft failure.

Conclusions:

• A lower CSBS, as determined by CCTA, is an independent prognostic factor for graft failure post-CABG.
• CCTA-derived CSBS can aid in pre-operative risk stratification for CABG patients.
• This scoring system may help identify patients at higher risk for adverse graft outcomes.