Preoperative Detection of Inadequate Saphenous Vein by Noncontrast Three-dimensional Computed Tomography

Abstract

Despite the widespread use and superior patency of the arterial graft for coronary artery bypass grafting (CABG), the saphenous vein (SV) continues to be the most commonly used graft. The SVs, however, sometimes have anatomical problems such as varicose veins, small or large diameter, and duplication. Ultrasonography has been the main modality for preoperative SV evaluation because of its simplicity and low invasiveness ; however, it has drawbacks, such as a lack of objectiveness, poor reproducibility, and difficulty in capturing the entire image of SV. Meanwhile, computed tomography (CT) can clearly visualize the SV without contrast. Although CT is performed as a standard preoperative examination for CABG in Japan, it is only used for evaluating the thoracoabdominal area in most facilities. To evaluate graft suitability of the SV preoperatively, we extended the CT scanning range to the lower extremities. The present study was conducted to clarify the usefulness of CT in the preoperative evaluation of the SV and to elucidate the incidence of an inadequate SV as a graft.