Author + information
- Received June 25, 1991
- Revision received August 26, 1991
- Accepted September 12, 1991
- Published online March 15, 1992.
- John E. Willard, MD∗,†,
- Dymphna Netto, MD∗,
- Saba E. Demian, MD∗,
- Don R. Haagen, RCPT∗,
- M.Elizabeth Brickner, MD∗,†,
- Eric J. Eichhorn, MD, FACC∗,† and
- Paul A. Grayburn, MD, FACC∗∗,†
- ↵∗Address for reprints: Paul A. Grayburn, MD, Division of Cardiology (III A), Veterans Affairs Medical Center, 4500 South Lancaster Road, Dallas, Texas 75216.
The ubiquity of coronary artery disease and the resultant widespread use of saphenous veins for coronary artery bypass surgery has stimulated considerable interest in the morphologic and pathophysiologic alterations these vessels undergo after implantation. This study was undertaken to determine the ability of intravascular ultrasound to identify and characterize abnormalities in saphenous vein grafts. Ten saphenous vein grafts excised at autopsy and nine saphenous vein segments harvested during coronary artery bypass surgery were examined with intravascular ultrasound imaging, quantitative coronary angiographic techniques and histologic analysis.
Intravascular ultrasound lumen measurements were strongly correlated with quantitative coronary arteriographic measurements (r 0.91, SEE 0.5 mm). Wall thickness was significantly greater in the vein grafts after long-term implantation than in the freshly harvested veins (average thickness 1.4 ± 0.5 vs. 0.7 ± 0.2 mm, p < 0.007); this finding correlated histologically with vein wall fibrosis. There was good correlation between ultrasound imaging and histologic analysis, with the ability to distinguish among normal intima, intimal hyperplasia, vein wall fibrosis and atheromatous plaque.
Thus, this preliminary study demonstrates the ability of intravascular ultrasound to provide real-time cross-sectional images of saphenous veins and morphologic characterization of their walls. This modality may have important clinical applications, including the ability to detect serial changes in vein graft intimal hyperplasia and atherosclerosis.
☆ This study was presented in part at the 63rd Scientific Sessions of the American Heart Association, Dallas, Texas, November 1990.
- Received June 25, 1991.
- Revision received August 26, 1991.
- Accepted September 12, 1991.