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Digital subtraction angiography of coronary grafts: optimization of technique.

Forty patients who had undergone coronary artery bypass surgery were studied with digital subtraction angiography (DSA) to develop an outpatient screening technique for coronary artery bypass graft visualization. Of 103 grafts in 40 patients, 101 were seen: 95 were clearly patent and in six the stump of an occluded graft was seen. Of 32 grafts seen in 14 patients using intraarterial DSA, only 13 (41%) were demonstrated using intravenous DSA. Intraarterial DSA is an effective screening procedure to determine bypass graft patency. However, volumes of 40-45 ml of 76% contrast medium injected at rates of at least 20 ml/sec must be used for each injection to obtain a diagnostic image, and since each projection is complementary and contributes some information, several injections must be used to complete an examination.