ECG-gated multi-detector computed tomography for failure of conventional coronarography to detect intraluminal thrombus in saphenous vein graft

The rate of saphenous vein graft (SVG) failure is ∼40% at 5 years. Thrombus formation is largely involved in SVG disease and occurrence of acute coronary syndromes. There is no uniform angiographic definition of intracoronary thrombus, and even if the strictest angiographic criteria require the observation of definite, intraluminal, globular filling defects seen in multiple angiographic views, these images are not present in all cases. Numerous studies have demonstrated the poor sensitivity of angiography for detecting intracoronary thrombi (as low as 20%). The sensibility is particularly low when the thrombus is located inside the lumen of the artery. The use of intravascular ultrasound enables the assessment …