Rationale and Objectives
Noninvasive diagnostic imaging of subclavian artery (SCA) and internal thoracic artery
(ITA) is crucial to the patients planning to use ITA for coronary artery bypass grafting
(CABG). The guidelines have not yet provided guidance on screening high-risk groups.
The present study aimed to evaluate the contribution of ultrasonography in the assessment
of SCA and ITA, especially for the patients referred for CABG who planned to use ITA
graft.
Materials and Methods
Patients diagnosed with multivessel coronary heart disease were enrolled and some
of them planned CABG. Bilateral SCAs and ITAs were routinely evaluated by color Doppler
ultrasound (CDUS) before operation. The luminal diameter and the peak systolic velocity
of the proximal and distal parts of SCA and ITA were measured. Depending on the Doppler
waveform, the lumen narrowing rate was calculated.
Results
The final analysis was carried out in 572 patients. Thirty-five patients had moderate
(50%-69%), severe (70%-99%) stenosis or occlusion in the SCA (left-sided in 21 and
right-sided in 14). One patient had severe proximal stenosis in left ITA and one patient
had no flow in left ITA due to the occlusion in left SCA. One patient had anatomic
variation of isolated right aortic arch with aberrant left SCA. All of those cases
were confirmed with multidetector computed tomography angiography.
Conclusion
CDUS could be used for the evaluation of SCA and ITA before CABG as part of presurgical
vascular assessment and provide an import basis for the imaging diagnosis and surgical
plan.
Key words
Abbreviations:
SCA (subclavian artery), ITA (internal thoracic artery), CABG (coronary artery bypass grafting), CDUS (color Doppler ultrasound), LITA (left internal thoracic artery), SAS (subclavian artery stenosis), CSSS (coronary subclavian steal syndrome), PSV (peak systolic velocity), D1 (residual diameter), D2 (original diameter), ICC (intra-class correlation coefficient), SSS (subclavian-vertebral artery steal syndrome), CTA (computed tomography angiography), RAA (right aortic arch), SVG (saphenous vein graft)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 09, 2022
Accepted:
June 13,
2022
Received in revised form:
June 4,
2022
Received:
April 28,
2022
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
