Work

The feasibility and accuracy of planning the length of grafts of coronary artery bypass grafting using syngo.via based on CCTA

Year: 2025

Type: article

Abstract: BACKGROUND: The Siemens syngo.via "Define vessel" module enables rapid vascular segmentation and precise length measurement, yet its utility for coronary artery bypass grafting (CABG) preoperative planning remains unvalidated. The present study aims to evaluate the accuracy of the "Define vessel" module in predicting CABG lengths based on coronary computed tomography angiography (CCTA) images. MATERIALS AND METHODS: About 74 CABG patients (May 2024-March 2025) from the Second Xiangya Hospital of Central South University were prospectively enrolled, excluding those with CCTA contraindications or incomplete data. Preoperative planning utilized CCTA and conventional angiography, with graft paths defined and measured using the "Define vessel" module. Postoperative CCTA was performed within 3 months. A total of 302 grafts were analyzed, comprising 67 left internal mammary artery (LIMA), 87 aorta-coronary (AO), 122 sequential, 12 Y-, and 14 right internal mammary artery (RIMA) grafts. RESULTS: LIMA grafts showed statistically significant ( P < 0.01) but clinically minor differences among preoperative (12.0 ± 1.5 cm), intraoperative (12.8 ± 1.5 cm), and postoperative (12.6 ± 1.7 cm). AO and sequential graft lengths also showed similar consistency with minor variations across stages [AO grafts: 11.6 cm (9.1-15.1) vs 11.6 cm (9.0-15.5) vs 11.4 cm (9.6-15.3); sequential grafts: 5.5 cm (4.2-7.2) vs 5.7 cm (4.4-7.5) vs 5.9 cm (4.1-7.1)]. In contrast, Y-grafts (3.5 ± 1.3 cm vs 3.3 ± 1.1 cm vs 3.3 ± 1.1 cm) and RIMA grafts (13.6 ± 1.1 cm vs 13.7 ± 1.1 cm vs 13.8 ± 1.4 cm) showed no statistically significant differences ( P > 0.05) among the three points. Preoperative, intraoperative, and postoperative measurements for all graft types demonstrated strong correlations ( r = 0.86-0.99) and excellent agreement (intraclass correlation coefficient = 0.74-0.99), confirming the reliability of preoperative planning. Bland-Altman analysis further confirmed minimal bias within clinically acceptable limits. Occlusion rates were as follows: LIMA 5.6% (4/71), AO 2.2% (2/89), sequential 6.9% (9/131), Y-grafts 7.7% (1/13), but no occlusions occurred in RIMA grafts. CONCLUSION: The "Define vessel" module provided a clinically reliable preoperative graft length estimation for CABG, demonstrating strong agreement with intraoperative and postoperative measurements, supporting its integration into preoperative planning workflows.

Source: International Journal of Surgery

DOI: 10.1097/js9.0000000000003812