Universität zu Köln

Houbois, Christian P., Karur, Gauri, Fratesi, Jennifer and McInnis, Micheal C. . Assessment of lateral costal artery with CT angiography: determination of prevalence and vessel length in the general population and its potential impact for coronary artery bypass grafting. Eur. Radiol.. NEW YORK: SPRINGER. ISSN 1432-1084

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Abstract

Objectives Standard treatment for severe coronary artery disease (CAD) is coronary artery bypass grafting (CABG). An underreported branch of the internal mammary artery, the lateral costal artery (LCA), can cause a steal phenomenon after CABG, resulting in angina. The aim of this study was to determine the prevalence and length of LCA based on CT angiography (CTA). Methods This retrospective study included adult patients undergoing a thoracic CTA between January 2016 and August 2018. Exclusion criteria were prior CABG, insufficient clinical information, or inadequate image quality. Two blinded, independent readers reviewed all studies for the prevalence of the LCA. Positive cases were reviewed by two readers (R1/R2) for side distribution and vessel length, measured in intercostal spaces (ICS). Study indication, aortic size, and coronary calcification were noted. Results LCA was present in up to 42/389 (11%) of studies (60.3 +/- 16.7 years, 30 males). The LCA was most commonly unilateral (n= 23, 55%). Median vessel length was 2 ICS (IQR 0; 3). Logistic regression was not significant in vessel distribution for sex (OR 0.6, 95% CI 0.28-1.15;p= 0.11). Inter-observer agreement in detecting LCA was substantial (kappa 0.71, 95% CI 0.59-0.83) and excellent for side/length distribution (kappa 0.94, 95% CI 0.82-1.0; ICC 0.96, 95% CI 0.93-0.98). Conclusion The LCA is uncommon and most often unilateral and extends the third rib. Radiologists should be aware of this vessel and its potential role in angina after CABG, particularly when large.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Houbois, Christian P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Karur, Gauri UNSPECIFIED UNSPECIFIED UNSPECIFIED Fratesi, Jennifer UNSPECIFIED UNSPECIFIED UNSPECIFIED McInnis, Micheal C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-318453
DOI:	10.1007/s00330-020-07292-9
Journal or Publication Title:	Eur. Radiol.
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1084
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTERNAL MAMMARY ARTERY; SIDE BRANCHES; EMBOLIZATION; DISEASE; ASSOCIATION; SURGERY; FLOW Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31845