POSTOPERATIVE ANGIOGRAPHIC EVALUATION OF GASTROEPIPLOIC ARTERY GRAFTS - TECHNICAL CONSIDERATIONS AND SHORT-TERM PATENCY

Follow‐up angiography was performed in 37 patients with right gastroepiploic artery (GEA) grafts at 27 ± 32 days postoperatively. By the femoral approach, a 5F cobra or twist catheter was advanced selectively into the gastroduodenal artery (GDA) over a plasticcoated guidewire. In 29 patients, the GDA was successfully catheterized, and the GEA grafts were clearly visualized by the injection of 3–7 ml of contrast medium. GDA catheterization was unsuccessful in 8 patients, but in 4 of them the grafts were well visualized when 15–20 ml of contrast was injected. In the other 4 patients, visualization of the GEA grafts was poor, but the distal portions were outlined by retrograde perfusion from the native right coronary arteries. A total of 34 GEA grafts were patent (92%), and the diameters of these grafts were adequate when compared with respective recipient coronary arteries (2.8 ± 0.9 and 2.3 ± 0.6 mm, respectively; P <.05). No complications were noted except for transient vasospasm (3 patients) in the GEA, hepatic artery, or both, which was relieved by the intra‐arterial injection of isosorbide dinitrate (2.5 mg). Thus, the overthe‐wire technique allows simple and safe GDA catheterization, which is essential for obtaining good visualization of GEA grafts. Copyright © 1990 John Wiley & Sons, Ltd.