A simple maneuver in intraarterial digital subtraction angiography (DSA) is proposed to improve the images of left internal thoracic artery bypass grafts (LITAGs). A contrast flush in the left subclavian artery, using a catheter that had been percutaneously introduced from the left brachial artery, was carried out in 14 patients with multiple coronary-aorta bypass grafts (CABGs) after aortic DSA. The side-hole portion of the catheter tip was positioned in the proximal left subclavian artery as the coiled portion remained in the aortic arch. Nonionic contrast medium (350 mg/ml of iodine) was injected with an automatic injector in a volume of 6-8 ml and at a flow rate of 3-4 ml/sec. Left subclavian arterial flush DSA delineated the LITAGs excellently in 11, well in 3, and fairly or poorly in none of the 14 cases. There were no complications in any of these cases. A supplemental contrast flush of the left subclavian artery with a pigtail catheter following aortic DSA improves the diagnosis of multiple CABG patency. coronary aorta bypass grafts (CABGs); intra-arterial digital subtraction angiography (IA-DSA) After coronary-aorta bypass graft (CABG) surgery, intraarterial digital subtraction angiography (DSA) through a transbrachial approach has been used for the evaluation of graft patency (Martin and Charles 1986; Richard and Donald 1990; Terada et al. 1990; Mancini 1991). Although aortic DSA has delineated saphenous vein grafts (SYGs) well, it does not clearly define left internal thoracic artery bypass grafts (LITAGs), which have been commonly used in current CABG
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.