Impact of proximal radiopaque coronary bypass graft markers on postbypass surgery coronary angiography

J Thorac Cardiovasc Surg. 2018 Apr;155(4):1565-1572. doi: 10.1016/j.jtcvs.2017.12.043. Epub 2017 Dec 19.

Abstract

Background: Implantation of radiopaque bypass graft markers during coronary artery bypass surgery (CABG) has the potential of facilitating subsequent coronary angiography. This study sought to investigate the impact of proximal coronary bypass graft markers on angiographic outcomes during subsequent coronary angiography in a large cohort.

Methods and results: Between 2005 and 2016, we enrolled 1378 patients (331 with and 1047 without bypass graft markers) with a history of CABG who underwent their first subsequent coronary angiography at our institution. Primary endpoints were radiation time and absolute amount of contrast media used. In unadjusted analyses, radiation time, duration of angiography, dose area product, and the amount of contrast agent were significantly lower in patients with proximal bypass graft markers (P < .001). After full adjustment, proximal coronary bypass graft markers remained a significant predictor for less radiation time and a lower consumption of contrast agent but not for dose area product, which was mainly associated with body mass index and sex. Bypass graft markers were not associated with a lower graft patency.

Conclusions: Radiopaque coronary bypass graft markers can improve the detection of bypass grafts during subsequent coronary angiography and are associated with a lower radiation time and less consumption of contrast agent. Thus, this easy and cost-efficient technique might significantly reduce the risk of coronary angiography after CABG.

Keywords: CABG; coronary angiography; radiopaque coronary bypass marker.

Publication types

  • Video-Audio Media

MeSH terms

  • Aged
  • Contrast Media / administration & dosage*
  • Contrast Media / adverse effects
  • Coronary Angiography / adverse effects
  • Coronary Angiography / instrumentation*
  • Coronary Artery Bypass / instrumentation*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / surgery*
  • Female
  • Fiducial Markers* / adverse effects
  • Humans
  • Male
  • Predictive Value of Tests
  • Radiation Dosage*
  • Radiation Exposure / adverse effects
  • Radiation Exposure / prevention & control*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Contrast Media