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Brazilian Journal of Cardiovascular Surgery

Print version ISSN 0102-7638On-line version ISSN 1678-9741

Abstract

WęGLARZ, Przemysław et al. Early Stage of Atherosclerosis in Aortocoronary Saphenous Vein Grafts: Intravascular Ultrasound Study. Braz. J. Cardiovasc. Surg. [online]. 2019, vol.34, n.5, pp.560-564.  Epub May 20, 2019. ISSN 0102-7638.  https://doi.org/10.21470/1678-9741-2018-0221.

Introduction:

Angiographically visible plaques in patent vein grafts are usually detected years after surgery. Our aim was to examine early plaque formation in vein grafts.

Methods:

Bypass angiography and intravascular ultrasonography (IVUS) examination were performed on 77 aortocoronary saphenous vein grafts (SVGs) implanted in 36 patients during the first 2 years after CABG. In each graft, a good quality 25 mm ultrasound image was analyzed. We measured: plaque area, lumen area, external elastic membrane (EEM) area, graft area and wall area. For the comparative assessment of SVGs, the index plaque area/EEM area was calculated. Data were analyzed for the following 4 time periods: I – 0-4 months (22 grafts), II – 5-8 months (23 grafts), III – 9-12 months (19 grafts) and IV – 13-16 months (13 grafts) after CABG. Student’s t and Fisher-Snedecor tests were used for the purpose of statistical analysis in this retrospective study.

Results:

In period I, plaque formation (neointimal) was observed in 10 grafts (45%), with a mean plaque area of 1.59 mm., in 6 grafts (26%) in period II, with a mean plaque area of 1.03 mm. and in 15 grafts (71%) in period III, with a mean plaque area of 1.41 mm., and in all (100%) grafts in period IV, with mean plaque area of 2,3 mm.. Average index plaque area/EEM area in periods I, II, III and IV were 0.12, 0.08, 0.13 and 0.22. We have showed a significant plaque increase between periods II and IV(P=0.038).

Conclusion:

IVUS showed plaque in about 40% of venous grafts during the first year after CABG. Between 13-16 months plaque was visible in all studied grafts.

Keywords : CABG; Venous Grafts; Prostheses; Atherosclerosis.

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