[Assessment of saphenous vein graft wall characteristics with intravascular ultrasound imaging].
The wall characteristics of saphenous vein grafts (SVGs) after coronary artery bypass grafting (CABG) were assessed with intravascular ultrasound (IVUS) imaging. Twenty-seven SVGs in 25 patients who had undergone CABG were studied with IVUS in vivo. Ten SVGs excised from 6 patients who had undergone reoperation were studied with IVUS in vitro. The results were compared with the histopathologic findings. IVUS images of four SVGs studied within 1 month after CABG showed a thin and single-layer structure, which was almost identical to the IVUS features of a normal, fresh SVG. In five SVGs studied between 3 months and 1 year after CABG, the wall thickness was increased, and there were hypoechoic areas. In sixteen SVGs studied more than 2 years after CABG, two patterns were noted on IVUS imaging. One pattern was a triple-layer structure of alternating hyperechoic, hypoechoic, and hyperechoic bands seen in the angiographically normal sections of the SVGs. The second pattern was a heterogeneous, echogenic monolayer found in the angiographically irregular and diseased sections of the SVGs. Comparison of the in vitro IVUS images with the histopathology of the SVGs showed a strong correlation between the triple-layer structure and fibrointimal proliferation, and between the heterogeneous monolayer and atherosclerosis. In conclusion, IVUS is useful for assessing SVGs and for long-term qualitative monitoring of vein graft disease after CABG.
Kobayashi
T
T
Division of Cardiovascular Surgery, Toranomon Hospital, Tokyo, Japan.
Makuuchi
H
H
Naruse
Y
Y
Sato
T
T
Fujiki
T
T
Ninomiya
M
M
Ogata
K
K
Komiyama
N
N
D001026:Coronary Artery Bypass; D006801:Humans; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000473:pathology / Q000637:transplantation*; D013997:Time Factors; D018084:Ultrasonography, Interventional