N. Komiyama et al., INTRAVASCULAR IMAGING OF SERIAL CHANGES OF DISEASE IN SAPHENOUS-VEIN GRAFTS AFTER CORONARY-ARTERY BYPASS-GRAFTING, The American heart journal, 132(1), 1996, pp. 30-40
To clarify the structural changes of saphenous vein grafts after coron
ary artery bypass grafting, intravascular ultrasound and angioscopic i
mages were obtained from 23 grafts in vivo and 5 grafts and 3 new vein
s in vitro; the images were compared with histologic findings. Intrava
scular ultrasound demonstrated a single-layered appearance at new vein
s and all of the angiographically normal grafts within 6 months after
surgery. A triple-layered appearance that might be related to the rema
rkably proliferative and degenerated intima was revealed histologicall
y at 73.3% of the normal sites of grafts between 5 and 10 years after
operation. In 83.3% of the stenoses at several years after operation,
angioscopy showed yellow atheromatous plaques, often with a friable su
rface; a heterogeneous, lucent echo pattern was revealed on intravascu
lar ultrasound. Thus intravascular ultrasound and angioscopy may he us
ed to identify the morphologic changes of grafts at different points a
fter implantation more precisely than conventional angiography.