Preoperative angiographie evaluation of the descending branch of the lateral femoral circumflex artery as a free graft in coronary artery bypass graft

Objectives

The purpose of this study is to assess by angiogram, the availability and variety of descending branches of the lateral femoral circumflex artery in coronary artery bypass graft. Methods: The diameter and length were measured by angiogram in 70 cases. Descending branches of the lateral femoral circumflex artery greater than 8 cm in length and a diameter over 2 mm were judged as available for coronary artery bypass graft. Comparisons were performed between the right and left, and in some cases, between the length by angiogram and intraoperatively. Results: Forty-eight cases (68.6%) were judged suitable for bypass. Twenty-one were suitable for bypass only on the right, 6 only on the left, and 21 were suitable for either side. In total, 33 descending branches of lateral femoral circumflex arteries were used. Reasons for exclusion were; existence of wall irregularity and/or stenosis (15.7%), medial position (12.9%), hypoplasty (10.0%), unidentified (8.6%), and insufficient imaging (5.7%). The diameter of the right side was significantly larger than the left (3.6 vs. 3.3 mm, p<0.01). In 21 cases, the length of the harvested descending branches of the lateral femoral circumflex artery measured intraoperatively was 10.8 cm (5 to 18 cm), that was 91% of the length measured by angiogram, and the lumen diameter was 3.2 mm in proximal, 2.3 mm in distal. Conclusion: As the availability of descending branches of the lateral femoral circumflex artery is limited and some varieties are recognized, preoperative angiogram is strongly recommended when it is planned for coronary artery bypass graft.