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. 2018;14(2):157-166.
doi: 10.5114/aic.2018.76407. Epub 2018 Jun 19.

Saphenous graft atherosclerosis as assessed by optical coherence tomography data for stenotic and non-stenotic lesions from the OCTOPUS registry

Grzegorz M Kubiak  1 , Elżbieta Pociask  2 , Wojciech Wańha  3 , Magdalena Dobrolińska  3 , Paweł Gąsior  3 , Grzegorz Smolka  3 , Andrzej Ochała  3 , Zbigniew Gąsior  4 , Wojciech Wojakowski  3 , Tomasz Roleder  4
Affiliations

Saphenous graft atherosclerosis as assessed by optical coherence tomography data for stenotic and non-stenotic lesions from the OCTOPUS registry

Grzegorz M Kubiak et al. Postepy Kardiol Interwencyjnej. 2018.

Abstract

Introduction: Coronary artery bypass grafting (CABG), although widely used for a long time in diffuse coronary artery disease (CAD), has serious limitations associated with graft aging and its degeneration.

Aim: The relationship between saphenous vein graft (SVG) plaque morphology assessed by optical coherence tomography (OCT) and clinical findings has not been elucidated yet.

Material and methods: We compared the morphology of SVG in stenotic vs. non-stenotic lesions using OCT imaging in 29 patients hospitalized in our center within the OCTOPUS registry.

Results: Stenotic lesions were characterized by higher incidence of thin-cap fibroatheroma (TCFA) (33% vs. 0%, p = 0.0048), thrombus (28% vs. 0%, p = 0.0008), lipid-rich plaque (LRP) (75% vs. 35%, p = 0.0013) and plaque within the SVG valve (19% vs. 0%, p = 0.0114) as compared to non-stenotic lesions. Patients with intimal tearing or rupture (ITR) were older (75.8% vs. 68.9 years, p = 0.047) and had lower left ventricular ejection fraction (LVEF) (32.0% vs. 49.7%, p = 0.001) and glomerular filtration rate (GFR) (36.0 vs. 73.6 ml/min/1.73 m2, p = 0.010). Patients with calcified lesions vs. those without had lower high-density lipoprotein (HDL) cholesterol (33.2 vs. 44.1 mg/dl, p = 0.018), similarly to those with ruptured plaque vs. those without (28.3 vs. 41.7 mg/dl, p = 0.047).

Conclusions: Presence of ITR was associated with advanced age, decreased LVEF and renal insufficiency. Decreased concentration of HDL was associated with higher occurrence of calcified and ruptured plaque.

Keywords: coronary artery bypass grafting; coronary artery disease; optical coherence tomography; saphenous vein graft; thin-cap fibroatheroma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Different types of plaque morphologies. A–F – show different types of plaque morphologies: A – calcified plaque, B – fibrotic plaque, C – intimal tearing, D – lipid-rich plaque, E – ruptured calcified plaque, F – calcified plaques
See this image and copyright information in PMC

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