Diagnostic Accuracy of Computed Tomography Angiography in Patients After Bypass Grafting

Weustink, Annick C.; Nieman, Koen; Pugliese, F.; Mollet, Nico R.; Meijboom, Bob; Mieghem, Carlos Van; Kate, Gert–Jan ten; Cademartiri, Filippo; Krestin, Gabriël P.; Feyter, Pim J. de

doi:10.1016/j.jcmg.2009.02.010

Cited by 107 publications

(67 citation statements)

References 24 publications

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“…The only report evaluating dual-source CTA for the assessment of significant graft disease in 52 symptomatic post-CABG patients, yielded a diagnostic accuracy of 100% [17]. This is consistent with the presented specificity and negative predictive value of 100%, whereas the occurrence of 3 false-positive findings resulted in lower sensitivity and positive predictive value in our study.…”

Section: Discussionsupporting

confidence: 90%

Dual-source computed tomography angiography in patients after bypass grafting – comparison with invasive coronary angiography

Kępka¹,

Opolski²,

Kruk³

et al. 2010

pwki

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A b s t r a c tBackground: Assessment of bypass grafts by invasive coronary angiography (ICA) is bothersome and often requires extra procedure time, contrast load, and radiation exposure.Aim: To evaluate the ability of dual-source computed tomography angiography (CTA) to detect significant graft disease in symptomatic patients after coronary artery bypass grafting (CABG).Methods: Thirty (26 men, mean age 66 ± 9 years) consecutive post-CABG patients from the prospective ANIN Computed Tomography Angiography Registry who underwent both dual-source CTA and ICA for suspected graft disease were included in the analysis. Coronary artery bypass grafts, anastomotic sites, and distal runoffs with a diameter of ≥ 1.5 mm were evaluated for the presence of significant stenoses (≥ 50% diameter reduction). Invasive coronary angiography served as a reference standard, and was performed within 30 days of dual-source CTA.Results: A total of 58 bypass grafts with 56 anastomotic sites, and 54 distal runoffs were evaluable both in dual-source CTA and ICA. Sensitivity, specificity, and positive and negative predictive values of dual-source CTA for the detection of significant lesions in bypass grafts were 100%, 92%, 86%, and 100%, respectively. In anastomotic sites, dual-source CTA detected significant stenosis with a sensitivity and specificity of 100% and 96%, respectively. If analysis was restricted to distal runoff segments, sensitivity and specificity were 50% and 98%, respectively. On a per-patient basis, all patients with at least one significant graft stenosis on ICA were correctly classified using dual-source CTA.Conclusions: Dual-source CTA permits the reliable assessment of bypass graft disease with high diagnostic accuracy and can be used in clinical routine as a noninvasive test to rule out suspected graft dysfunction in symptomatic post-CABG patients.Key words: dual-source computed tomography angiography, coronary artery bypass grafts, anastomotic sites, distal runoff segments S t r e s z c z e n i e Wstęp: Ocena pomostów aortalno-wieńcowych w inwazyjnej koronarografii często wiąże się z wydłużeniem czasu badania, podaniem dużej ilości kontrastu oraz większą dawką skuteczną promieniowania.Cel: Ocena dokładności dwuźródłowej tomografii komputerowej tętnic wieńcowych (CTA) w wykrywaniu istotnych zwężeń w pomostach u chorych z objawami po operacji pomostowania aortalno-wieńcowego (CABG).Metodyka: Do analizy włączono kolejnych 30 chorych (26 mężczyzn, średni wiek 66 ± 9 lat) po CABG z prospektywnego Rejestru Tomografii Komputerowej Tętnic Wieńcowych ANIN, u których wykonano badanie CTA oraz inwazyjną koronarografię. Ocenie poddano pomosty aortalno-wieńcowe, anastomozy oraz dystalne segmenty tętnic natywnych o średnicy ≥ 1,5 mm. Za istotne zwężenie przyjęto zmianę ≥ 50% redukcji światła naczynia. Wyniki analizy w CTA zostały porównane z inwazyjną koronarografią jako metodą referencyjną. Odstęp czasowy między CTA a koronarografią wyniósł ≤ 30 dni.Wyniki: Do analizy włączono 58 pomostów, 56 anastomoz oraz 54 segmenty dystalne ...

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Section: Discussionsupporting

confidence: 90%

Dual-source computed tomography angiography in patients after bypass grafting – comparison with invasive coronary angiography

Kępka¹,

Opolski²,

Kruk³

et al. 2010

pwki

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“…Assessment of CABG (▶ Table 1) Many studies listed in ▶ Table 1 achieved a negative predictive value and sensitivity of 100 % or nearly 100 % in 64-slice MDCT and beyond [15,16]. The sensitivity and specificity ranged between 80 -100 % and 93 -100 % in the detection of graft stenosis > 50 % and graft occlusion.…”

Section: Diagnostic Accuracy Of Md-ctamentioning

confidence: 99%

“…▶ Table 3 lists all studies that additionally analyzed native coronary arteries. 7 out of 13 studies evaluated native coronary arteries, whereas 3 of these publications differentiate between distal runoffs (segment of the coronary artery at which the bypass graft was inserted and all segments distally to the inserted segment) and non-grafted coronary arteries [15].…”

Section: Assessment Of Native Coronary Arteries (▶mentioning

confidence: 99%

Multidetector Computed Tomography Angiography (MD-CTA) of Coronary Artery Bypass Grafts – Update 2017

Jungmann

Emrich

Mildenberger

et al. 2017

Fortschr Röntgenstr

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ZUSAMMENFASSUNGHintergrund Die aortokoronare Bypassoperation stellt unverändert einen wichtigen Bestandteil in der Behandlung der koronaren Herzerkrankung insbesondere in fortgeschrittenen Krankheitsstadien dar. In der vorliegenden Arbeit soll der aktuelle Stellenwert der Multidetektor-CT-Angiografie (MD-CTA) bei Patienten nach stattgehabter aortokoronarer Bypassoperation (ACVB) dargelegt werden.

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“…8 This includes patients with bypass grafts and stents [3.0mm. 9,10 The advent of new techniques is likely to reach smaller stents. 11 It remains a puzzle as to why CTA is singled out by the US.…”

Section: Slant Toward Invasive Coronary Angiographymentioning

confidence: 99%

The unsaid word

Christian

2017

Journal of Nuclear Cardiology

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Diagnostic Accuracy of Computed Tomography Angiography in Patients After Bypass Grafting

Abstract: Noninvasive CTA is successful for evaluating bypass grafts in symptomatic post-CABG patients, whereas invasive coronary angiography is still required for the assessment of significant stenosis in distal runoffs and native coronary arteries.

Cited by 107 publications

References 24 publications

Dual-source computed tomography angiography in patients after bypass grafting – comparison with invasive coronary angiography

Dual-source computed tomography angiography in patients after bypass grafting – comparison with invasive coronary angiography

Multidetector Computed Tomography Angiography (MD-CTA) of Coronary Artery Bypass Grafts – Update 2017

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