CT angio for the evaluation of graft patency

In spite of the growth of percutaneous myocardial revascularization during the last years, the role of surgical myocardial revascularization is still well established, along with known better long-term results than percutaneous revascularization in specific groups of patients. This fact, associated with the long-term results of current techniques of total arterial myocardial revascularization, makes evaluation of graft patency largely unavoidable. Traditionally, graft patency has been evaluated with invasive coronary angiography (ICA) but, since the advent of multidetector computed tomography (MDCT), the temptation to use a noninvasive and widely available technique to study coronary artery bypass graft (CABG) patients has been stronger. While considering 4-slice or 16-slice MDCT as a reliable replacement of ICA for graft imaging could be questionable, the introduction of new scanners—64-slice and 128-slice upwards°？along with new scan protocols opens new perspectives in non-invasive assessment of graft patency. In this review, we will analyze the advantages and disadvantages of both invasive and non-invasive techniques, and we will explore potential future improvements in non-invasive graft imaging