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Journal of Radiological Review 2020 July-August;7(4):275-8

DOI: 10.23736/S2723-9284.20.00031-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

Computerized tomographic angiography in patients having external stent supported coronary saphenous vein grafts

Michele BINI 1 , Simona VEGLIA 2, Domenica GARABELLO 2, Giorgio LIMERUTTI 2

1 Department of Radiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy; 2 Institute of Radiology, Città della Salute e della Scienza, Turin, Italy


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In coronary artery bypass grafting (CABG), the use of the saphenous vein is necessary in over 80% of surgical cases to complete revascularization. The Achilles heel is that current vein graft failure rates range from 35 to 50% 5 to 10 years following CABG surgery compared to arterial graft. Recent clinical studies have demonstrated that external stenting of saphenous vein grafts (VEST) significantly reduces diffuse intimal hyperplasia. In our study, we evaluated the patency in 4 patients receiving VEST on a intermedium follow-up from their procedure (3-6 month), using computed tomography angiography (CTA). Graft patency was classified using three grade scale: ≤50% stenosis, ≥50% stenosis or occluded graft; graft failure was defined as ≥50% stenosis, compared with lumen of bypass before VEST. We also described run-off of distal vase qualitatively as good, medium, or poor. The quality of all exams was optimal for diagnosis of graft patency. All patients had patent VEST: in 3 patients CTA showed normal area of intra-stent lumen and good distal run-off. One patient had proximal stenosis of <50%, normal area of intra-stent lumen, distal stenosis of <50% and poor run-off of distal vase. No graft revisions were performed following CTA. In patients with external stenting of saphenous vein grafts, CTA is an available diagnostic method capable of providing results with a high level of diagnostic accuracy in follow-up.


KEY WORDS: Computed tomography angiography; Coronary artery bypass; Stents; Saphenous vein

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