Tamar Gaspar MD, Presenter: Nothing to Disclose

Nathan Peled MD, Abstract Co-Author: Nothing to Disclose

It is standard practice to use the left internal mammary artery (LIMA) for coronary artery bypass. Imaging of this artery is not performed prior to surgery unless there are specific complaints. We aim to evaluate the incidence of left SCA stenosis in asymptomatic patients with suspected Carotid artery disease referred for computed tomography angiography (CTA).

: 143 patients (80 male, 63 female, mean age 69.9 years) with suspected carotid artery disease were scanned on a 16-slices CT scanner (Mx8000IDT, Philips) from the level of the aortic arch to the base of the skull. Axial helical scans with collimation of 16x0.75mm and reconstructed slice thickness of 1.0mm with an increment of 0.5mm were performed after a mean 70cc (60-120cc) IV contrast injection.

In 60% (85/143) the proximal segment of the left SCA, before the origin of the LIMA, was normal. In 40% (58/143) there were atherosclerotic changes in this segment. In 25% (36/143) there was up to 50% stenosis, and in 15% (22/143) there was significant stenosis (above 50%) to total occlusion of this vessel.

The incidence of atherosclerotic changes in the left SCA of asymptomatic patients with suspected carotid artery disease was 40% in our study. Since many of these patients also suffer from ischemic heart disease and may require CABG, routine imaging of these arteries is recommended prior to surgery.

Gaspar, T, Peled, N, Should Routine Imaging of the Subclavian Arteries (SCA) Be Performed prior to Coronary Artery Bypass Grafting (CABG)?.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4406033.html