Analysis of Saphenous Vein Graft Lesion Composition Using Near-Infrared Spectroscopy and Intravascular Ultrasonography With Virtual Histology

OBJECTIVES: To examine the composition of saphenous vein graft (SVG) lesions using two novel modalities, near-infrared spectroscopy (NIRS) and intravascular ultrasonography with virtual histology (IVUS-VH).

METHODS: We performed NIRS and IVUS-VH imaging of 23 SVGs in 21 patients undergoing clinically-indicated angiography.

RESULTS: Mean patient and SVG age was 66+/-7 and 10+/-7 years, respectively. SVG lesion location was aorto-ostial in 8 (35%), body in 13 (57%) and distal anastomotic in 2 (9%). Compared to anastomotic lesions, body lesions had larger mean lumen area (6.4+/-1.8mm(2) vs. 4.2+/-6.4mm(2), P=0.02) but similar mean plaque burden (73+/-5% vs. 70+/-10%, P=0.66). A NIRS lipid core plaque was identified in 9 of 13 body lesions vs. 1 of 10 anastomotic lesions (69% vs. 10%, P=0.005). SVG body lesions had higher lipid core burden index (LCBI) compared to anastomotic lesions (184+/-76 vs. 49+/-54, P<0.001). By IVUS-VH, SVG lesions had high % necrotic core (28+/-10%) and % dense calcium (13+/-10%), without any significant difference between body and anastomotic sites. Older SVG age was associated with higher lesion and vessel LCBI (r=0.76 and r=0.64, respectively, P<0.001), but was not associated with IVUS-VH determined plaque composition. Higher HDL-cholesterol was associated with lower lesion LCBI (r=-0.43, P=0.04).

CONCLUSIONS: NIRS-measured lipid core plaque in SVGs increases with increasing SVG age and is infrequent in anastomotic lesions. No association was found between IVUS-VH plaque composition measurements and SVG lesion location or age. Isaac Rochell Authentic Jersey

PMID: 20673899

Posted in Invasive Imaging and tagged , , , .

2 Comments

  1. Please see the following:

    Virtual histology by intravascular ultrasound study on degenerative aortocoronary saphenous vein grafts.
    Jim MH, Hau WK, Ko RL, Siu CW, Ho HH, Yiu KH, Lau CP, Chow WH.
    Can J Cardiol. 2009 Sep;25(9):509-15.
    PMID:

  2. Eventually, it will be interesting to see results from serial trial.

    A multicenter, randomized, double-blind placebo-controlled trial evaluating Rosiglitazone for the prevention of atherosclerosis progression after coronary artery bypass graft surgery in patients with type 2 diabetes. Design and rationale of the Vein-Coronary atherosclerosis and Rosiglitazone after bypass surgery (VICTORY) trial.
    Bertrand OF, Poirier P, Rodés-Cabau J, Rinfret S, Title L, Dzavik V, Natarajan M, Angel J, Batalla N, Alméras N, Costerousse O, De Larochellière R, Roy L, Després JP; VICTORY trial investigators.

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