64 slice-coronary computed tomography sensitivity and specificity in the evaluation of coronary artery bypass graft stenosis: A meta-analysis

Barbero, Umberto; Iannaccone, Mario; D’Ascenzo, Fabrizio; Barbero, Cristina; Allaoui, Mohamed; Annone, Umberto; Benedetto, Sara; Celentani, Dario; Gagliardi, Marco; Moretti, Claudio; Gaïta, Fiorenzo

doi:10.1016/j.ijcard.2016.04.156

Cited by 65 publications

(35 citation statements)

References 33 publications

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“…A systemic review of Chan and colleagues involving 1975 patients and 5364 grafts demonstrated that MDCT had the aggregated sensitivity and speci city of 98% (95% CI: 97-99%) and 98% (95% CI: 96-98%) in the assessment of bypass graft occlusion and stenosis [5]. Similarly, a study of Barbero and colleagues concluded that the diagnostic sensitivity and speci city for combined assessment of occlusion and stenosis were both over 98% [6]. Although MDCT could not replace ICA in conduit patency assessment after CABG at present, MDCT can obtain clear graft images and plays a crucial role in the evaluation of grafts, especially for asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

Short-term Assessment of Radial Artery Grafts With Multidetector Computed Tomography

Qiao

Wang

et al. 2020

Preprint

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Background The clinical use of radial artery (RA) in coronary artery bypass grafting (CABG) is still limited worldwide, although it has been recommended by several guidelines, and the application of multidetector computed tomography (MDCT) in the evaluation of graft patency is still to be verified. This study aims to report the short-term results of RA in CABG with MDCT. Methods The study population consists of 41 consecutive patients undergoing elective CABG with the RA graft between 2007 to 2008, with MDCT performed to evaluate graft patency during follow-up, and target vessels for the RA were non-left anterior descending coronary arteries with > 70% stenosis. Results MDCT could clearly show the structure and patency of grafts, even for complex coronary artery revascularization. A total of 150 distal anastomoses were assessed by MDCT during follow-up (mean, 8.9 ± 5.1 months). Functional graft patency of the left internal mammary artery (LIMA) was 92.9% (39/42), with the RA patency of 84.4% (38/45) and the patency of saphenous vein graft (SVG) of 81.1% (30/37). And the RA targeting the left coronary artery system might have better patency than that of the RA targeting the right coronary artery system (25/29, 86.2% vs 13/16, 81.3%, p = 0.686). Conclusions MDCT could provide excellent visualization of grafts in CABG. The short-term patency rate of RA grafts is good, and the RA might be associated with better patency when targeted to the left but not the right coronary artery.

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Section: Discussionmentioning

confidence: 99%

Short-term Assessment of Radial Artery Grafts With Multidetector Computed Tomography

Qiao

Wang

et al. 2020

Preprint

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“…Earlier venous graft disease detection and evaluation of extracardiac anatomical features are additional advantages of CT-CAG. 8…”

Section: Key Issues In Coronary Imagingmentioning

confidence: 99%

Role of Computerized Tomography in Evaluation of Coronary Bypass Grafts—Special Reference to Women

et al. 2020

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Computerized tomography-coronary angiography (CT-CAG) is gaining popularity as an alternative to conventional CAG to evaluate grafts in a post-coronary artery bypass graft (post-CABG) patient, since it is a noninvasive procedure and is less influenced by cardiac motion. The primary challenge is to image a rapidly beating heart. With introduction of 64-slice scanner, the coronary imaging became a possibility with acceptable accuracy. In recent years, with the development of 128,256 and 320 multislice CT scanners, further enhancement in the temporal and spatial resolution is achieved due to lesser influence of the respiratory and cardiac motion, enhancing the accuracy of the lesion assessment in the grafts and the native vessels. Achieving low heart rate and artifact-free image acquisition, proper reconstruction, and image interpretation are challenges to the radiologists and the technicians involved in coronary imaging. Women pose special subset because of smaller sized coronary vessels, interference due to breast shadows, low-referrals, and gender-specific reluctance to accept the procedure itself. Cardiologists and radiologists caring for these patients must be familiar with the pros and cons of CT-CAG and gender-specific challenges.

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“…This role is termed as the potential "gatekeeper" role of CTA in the meta-analysis study performed by Barbero et al They concluded that ICA has a higher cost compared to CTA, and it is inconvenient for most of the patients due to the need for sedation with resultant driving restrictions, as well as a low risk of stroke, infarction, dissection, arrhythmia, or death. On the other hand, CTA is a noninvasive procedure, and it is highly accepted by patients [9].…”

Section: The Value Of Cta In the Context Of Cardiovascular Imaging Fomentioning

confidence: 99%

Evaluation of Coronary Artery Bypass by CT Coronary Angiography

Donkol¹,

Mahmoud²,

Elrawy³

2017

Coronary Artery Bypass Graft Surgery

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Coronary computed tomography angiography (CCTA) is an accurate method for graft imaging and assessment than invasive coronary angiography (ICA). CTA has excellent sensitivity and specificity. The chapter describes the role of CTA in evaluation of coronary bypass graft. It covers the appropriate indications for performing CTA after bypass operation, patient preparation, as well as protocol and technique of CTA. The chapter describes the post-examination processing of the images and how to interpret CTA images for detection of graft patency or dysfunction as occlusion, partial thrombosis, poor blood flow, and stealing flow from native artery. According to the American College of Cardiology, the American College of Radiology, and the North American Society for Cardiovascular Imaging, graft patency assessment with CTA is an appropriate approach in symptomatic patients at risk for graft stenosis/occlusion. Cardiac CT can be used to assess the patency of coronary artery bypass graft (CABG) with high diagnostic accuracy compared with ICA and even with a better performance compared to the assessment of native coronaries.

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64 slice-coronary computed tomography sensitivity and specificity in the evaluation of coronary artery bypass graft stenosis: A meta-analysis

Cited by 65 publications

References 33 publications

Short-term Assessment of Radial Artery Grafts With Multidetector Computed Tomography

Short-term Assessment of Radial Artery Grafts With Multidetector Computed Tomography

Role of Computerized Tomography in Evaluation of Coronary Bypass Grafts—Special Reference to Women

Evaluation of Coronary Artery Bypass by CT Coronary Angiography

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