Author + information
- Eric Fuh,
- Andrew Hester,
- Vishal Patel,
- Owen Mogabgab,
- Shuaib Abdullah,
- Subhash Banerjee and
- Emmanouil Brilakis
Percutaneous coronary intervention (PCI) of aortocoronary saphenous vein bypass grafts (SVGs) is associated with high risk for periprocedural myocardial infarction in large part due to distal embolization, which may be related to lesion lipid content. Near–infrared spectroscopy allows in vivo assessment of SVG lesion composition.
Between 2009 and 2012, 16 patients with 17 SVG lesions underwent NIRS before percutaneous coronary intervention (PCI). We evaluated for the presence of lipid core plaque (LCP, defined as at least 2 contiguous yellow blocks on block chemogram) and its impact on PCI outcomes.
Mean patient and SVG age was 65±6 and 10±6 years respectively. LCP was present in 8 SVG (47%). Mean vessel lipid core burden index (LCBI) was 68±55 and the 4mm maximum LCBI (LCBI4mm) was 278±207. The SVG lesion location was aorto–ostial (n=8, 47%), body (n=8, 47%), or distal anastomotic (n=1, 6%). Lesion age and minimum lumen diameter were similar in anastomotic vs. body lesions, yet the SVG body lesions had higher lipid content (Table). The incidence of post PCI myocardial infarction and target vessel revascularization over a median follow–up of 35±13 months were comparable for SVG body vs anastomotic lesions and LCP–containing vs no LCP–containing lesions.
Compared to anastomotic lesions, SVG body lesions are more likely to contain lipid core plaque, as assessed by NIRS.
Table: Characteristics of saphenous vein graft lesions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Interventional Aspects of CT and Other Novel Imaging Approaches
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2112–264
- 2013 American College of Cardiology Foundation