Midterm follow-up of patients receiving radial artery as coronary artery bypass grafts using 16-detector-row CT coronary angiography.
OBJECTIVE
The study was undertaken to evaluate the 3-year outcome of patients undergoing coronary artery bypass grafting (CABG) involving the use of the radial artery (RA) in comparison with the left internal mammary artery (LIMA) and saphenous vein (SV) grafts by using 16-slice multidetector computed tomography (MDCT).


METHODS
Fifty-one patients underwent electrocardiogram (ECG)-gated 16-MDCT 32+/-4 months after surgery. A total of 50 LIMA grafts, 55 SV grafts and 51 RA grafts were studied. Approximately 68.6% or RAs were free, 21.5% sequential and 9.8% composite. Grade 0 was defined as complete patency, grade 1 as focal stenosis (>70%) and grade 2 as graft occlusion. The Fisher exact test was used to analyse variables (p<0.05 significant). Concordance between readers for the detection of patency was calculated by the kappa-value.


RESULTS
LIMA had the best patency rate (94.0%), followed by SV (83.6%) and RA (74.5%). Regarding RA, the patency rate by territory was 79.4% in the left circumflex coronary artery (LCX), 72.7% in the left anterior descending (LAD) and 50% in the right coronary artery (RCA); the occlusion rate was 20.0% among free grafts, 18.2% among sequential grafts and 20.0% among composite grafts. The kappa-value was 0.86.


CONCLUSIONS
Sixteen-slice MDCT scanners enable accurate analysis of CABG status and are a useful noninvasive diagnostic tool for midterm clinical follow-up of patients who have undergone CABG involving the use of RA.
Crusco
F
F
Dipartimento Diagnostica per Immagini, AUSL 3 Umbria, Via Antica Vena 18, I-06087 Ospedale Foligno, Perugia, Italy. fcrusco@sirm.org
Antoniella
A
A
Papa
V
V
Menzano
R
R
Di Lazzaro
D
D
Di Manici
G
G
Ragni
T
T
Giovagnoni
A
A
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation*; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D014057:Tomography, X-Ray Computed