Intracoronary Imaging for Bypass Graft Assessment and Intervention

AbstractPurpose of ReveiwTo compile knowledge of expected intravascular imaging findings in coronary venous and arterial bypass grafts, both at baseline and in diseased states in order to improve understanding of the pathology demonstrated in failing grafts. Also, to learn how intravascular imaging could be used to guide necessary graft interventions and to consider whether imaging practices in grafts could become formalized or potentially influence outcomes of graft interventions, which are notoriously poor.Recent FindingsDisease in saphenous vein grafts has features overlapping with pathology in native vessels, but can also involve unique findings which have been described in studies and can be delineated well with intravascular imaging. The latter has also been used successfully to examine findings in internal mammary as well as radial artery grafts, particularly in the peri-operative period. Previously reported cases, as well as a case example here, show the feasibility and potential utility of these imaging modalities within grafts to guide coronary intervention.SummaryIntravascular imaging within bypass grafts is feasible and expected findings can be recognized and understood with review of existing data and with clinical experience gained in individual operator practice. Future directions could explore guidelines for imaging-guided intervention within bypass grafts and could examine whether outcomes could be improved with intravascular imaging guidance.

Source: Current Cardiovascular Imaging Reports - October 8, 2021 Category: Radiology Source Type: research