Impact of proximal radiopaque coronary bypass graft markers on postbypass surgery coronary angiography

Abstract

Radiopaque coronary bypass graft markers can improve the detection of bypass grafts during subsequent coronary angiography and are associated with a lower radiation time and less consumption of contrast agent. Thus, this easy and cost-efficient technique might significantly reduce the risk of coronary angiography after CABG.

Surgically placed radiopaque markers: Proof‐of‐concept of a novel technique to facilitate percutaneous interventions in neonates and infants

“…In an analysis of 1,378 adult patients in whom the impact of radiopaque coronary bypass graft markers on postoperative coronary angiography was investigated, bypass graft markers were found to be a significant predictor for less radiation time and reduced use of contrast agent. 13 In a larger pediatric patient series, these positive effects would most likely also be noticeable. There are no radiopaque markers approved for pediatric patients commercially available, thus implying their off-label use or this in-house production, respectively.…”

“…This technique has delivered beneficial results in adult patients when used as coronary bypass markers to simplify post-bypass coronary angiography, but it has not been described in a pediatric population so far. [13][14][15][16] Aim of this study was to evaluate the feasibility and benefit of surgically placed, self-designed, radiopaque markers as a novel technique to facilitate postoperative cardiac catheterization in neonates and infants with shunt-or duct-dependent lesions.…”

Coronary Artery Bypass: Review of Surgical Techniques and Impact on Long-Term Revascularization Outcomes

“…Coronary angiography in patients who have undergone previous CABG poses unique challenges due to potential uncertainty in the number and exact location of proximal anastomoses of aortocoronary grafts, which can lead to patients receiving increased does of fluoroscopic radiation and intravenous contrast to obtain a satisfactory exam [ 98 ]. Proximal anastomotic markers (PAMs), composed of a variety of materials, including standard surgical clips, metal or radiopaque silicone rings, segments of stainless-steel wire, segments of the radiopaque monofilament thread used in surgical sponges, or other materials, can be affixed adjacent to or circumferentially around proximal anastomoses of aortocoronary bypass grafts to facilitate their fluoroscopic identification [ 99 , 100 ].…”

“…The presence of PAMs was associated with significant comparative reductions in duration of angiography, fluoroscopy time, and contrast dose. There was also no relationship between the presence of PAMs and vein graft patency at a mean of 112 (with PAM) to 115 (without PAM) months of follow-up [ 98 ].…”

Do radiopaque markers make a difference after coronary artery bypass grafting?

“…In this issue of the Journal, Pingpoh and colleagues 1 describe a nice study in which they examined the impact of proximal radiopaque markers placed during coronary artery bypass grafting (CABG) on radiation exposure and contrast dose during subsequent graft angiography. This is not a new topic.…”