Darragh Brady, MD; Gerard M. Healy, MD; Jonathan D. Dodd, MD, MSc, MRCPI, FFR(RCSI)
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
Coronary artery bypass graft (CABG)
Definitions
Saphenous vein graft failure due to subtotal or total occlusive thrombosis
Thrombosis, intimal hyperplasia, and accelerated atherosclerosis contribute to graft failure in acute, subacute, and late postoperative periods, respectively
In early (< 1 month) postoperative period, acute thrombosis is dominant etiology
Technical failure may contribute
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Hillis LD et al: 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 124(23):2610-42, 2011. Erratum in: Circulation. 124(25):e956, 2011. Circulation. 126(7):e105, 2012
Brilakis ES et al: Drug-eluting stents versus bare-metal stents in saphenous vein grafts: a double-blind, randomised trial. Lancet. 391(10134):1997-2007, 2018
Zhao Q et al: Effect of ticagrelor plus aspirin, ticagrelor alone, or aspirin alone on saphenous vein graft patency 1 year after coronary artery bypass grafting: A randomized clinical trial. JAMA. 319(16):1677-86, 2018
Lee M et al: Current state of the art in approaches to saphenous vein graft interventions. Interv Cardiol. 12(2):85-91, 2017
McKavanagh P et al: Management and prevention of saphenous vein graft failure: A review. Cardiol Ther. 6(2):203-23, 2017
Chan M et al: A systematic review and meta-analysis of multidetector computed tomography in the assessment of coronary artery bypass grafts. Int J Cardiol. 221:898-905, 2016
Gluckman TJ et al: Effects of aspirin responsiveness and platelet reactivity on early vein graft thrombosis after coronary artery bypass graft surgery. J Am Coll Cardiol. 57(9):1069-77, 2011
Parang P et al: Coronary vein graft disease: pathogenesis and prevention. Can J Cardiol. 25(2):e57-62, 2009
Ropers D et al: Diagnostic accuracy of noninvasive coronary angiography in patients after bypass surgery using 64-slice spiral computed tomography with 330-ms gantry rotation. Circulation. 114(22):2334-41; quiz 2334, 2006
Frazier AA et al: Coronary artery bypass grafts: assessment with multidetector CT in the early and late postoperative settings. Radiographics. 25(4):881-96, 2005
Enzweiler CN et al: Diameter changes of occluded venous coronary artery bypass grafts in electron beam tomography: preliminary findings. Eur J Cardiothorac Surg. 23(3):347-53, 2003
Stone GW et al: Prospective, randomized evaluation of thrombectomy prior to percutaneous intervention in diseased saphenous vein grafts and thrombus-containing coronary arteries. J Am Coll Cardiol. 42(11):2007-13, 2003
Shuhaiber JH et al: Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery. Eur J Cardiothorac Surg. 22(3):387-96, 2002
Fitzgibbon GM et al: Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol. 28(3):616-26, 1996
Mak KH et al: Subacute stent thrombosis: evolving issues and current concepts. J Am Coll Cardiol. 27(2):494-503, 1996
Walts AE et al: Thrombosed, ruptured atheromatous plaques in saphenous vein coronary artery bypass grafts: ten years' experience. Am Heart J. 114(4 Pt 1):718-23, 1987
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
Coronary artery bypass graft (CABG)
Definitions
Saphenous vein graft failure due to subtotal or total occlusive thrombosis
Thrombosis, intimal hyperplasia, and accelerated atherosclerosis contribute to graft failure in acute, subacute, and late postoperative periods, respectively
In early (< 1 month) postoperative period, acute thrombosis is dominant etiology
Technical failure may contribute
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Hillis LD et al: 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 124(23):2610-42, 2011. Erratum in: Circulation. 124(25):e956, 2011. Circulation. 126(7):e105, 2012
Brilakis ES et al: Drug-eluting stents versus bare-metal stents in saphenous vein grafts: a double-blind, randomised trial. Lancet. 391(10134):1997-2007, 2018
Zhao Q et al: Effect of ticagrelor plus aspirin, ticagrelor alone, or aspirin alone on saphenous vein graft patency 1 year after coronary artery bypass grafting: A randomized clinical trial. JAMA. 319(16):1677-86, 2018
Lee M et al: Current state of the art in approaches to saphenous vein graft interventions. Interv Cardiol. 12(2):85-91, 2017
McKavanagh P et al: Management and prevention of saphenous vein graft failure: A review. Cardiol Ther. 6(2):203-23, 2017
Chan M et al: A systematic review and meta-analysis of multidetector computed tomography in the assessment of coronary artery bypass grafts. Int J Cardiol. 221:898-905, 2016
Gluckman TJ et al: Effects of aspirin responsiveness and platelet reactivity on early vein graft thrombosis after coronary artery bypass graft surgery. J Am Coll Cardiol. 57(9):1069-77, 2011
Parang P et al: Coronary vein graft disease: pathogenesis and prevention. Can J Cardiol. 25(2):e57-62, 2009
Ropers D et al: Diagnostic accuracy of noninvasive coronary angiography in patients after bypass surgery using 64-slice spiral computed tomography with 330-ms gantry rotation. Circulation. 114(22):2334-41; quiz 2334, 2006
Frazier AA et al: Coronary artery bypass grafts: assessment with multidetector CT in the early and late postoperative settings. Radiographics. 25(4):881-96, 2005
Enzweiler CN et al: Diameter changes of occluded venous coronary artery bypass grafts in electron beam tomography: preliminary findings. Eur J Cardiothorac Surg. 23(3):347-53, 2003
Stone GW et al: Prospective, randomized evaluation of thrombectomy prior to percutaneous intervention in diseased saphenous vein grafts and thrombus-containing coronary arteries. J Am Coll Cardiol. 42(11):2007-13, 2003
Shuhaiber JH et al: Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery. Eur J Cardiothorac Surg. 22(3):387-96, 2002
Fitzgibbon GM et al: Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol. 28(3):616-26, 1996
Mak KH et al: Subacute stent thrombosis: evolving issues and current concepts. J Am Coll Cardiol. 27(2):494-503, 1996
Walts AE et al: Thrombosed, ruptured atheromatous plaques in saphenous vein coronary artery bypass grafts: ten years' experience. Am Heart J. 114(4 Pt 1):718-23, 1987
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