Optical coherence tomography in grafts

Coronary artery bypass graft (CABG) is a commonly used surgery to treat patients with complex artery disease. Long-term outcome of specifically saphenous vein grafts (SVG) is considered unfavorable, while it is the most commonly used conduit. The SVG is prone to occlude and half of the patients will develop vein graft failure (VGF) within 10 years. VGF is the result of the accelerated atherosclerosis that differs from what is seen in native coronaries. Revascularization of SVGs is considered challenging, due to their challenging anatomy and embolic nature. Optical coherence tomography (OCT) imaging is an invasive imaging technique that can be used to get a visual assessment of the development of this process. It is able to generate high-resolution cross-sectional images of the vessel. Ultimately, this could lead to a better understanding of VGF and possibly a better way of anticipating and treating complications. This chapter will discuss the challenges of OCT in SVG and the feasibility, findings, and potential clinical applications of OCT in saphenous vein grafts.

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