This was the largest of such trials to date, and a supplement of 8 g/d of omega-3 fatty acids failed to prevent the usual high rate of restenosis after PTCA. No adverse effects were attributable to this large daily supplement of omega-3 fatty acids.

Summary:In the last 15 years, intense interest has focused on various interventional pharmacologic and mechanical forms of therapy for the treatment of atherosclerosis coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional Part I of this review will focus on anatomic aspects of the epicardial coronary artery system, coronary arterial distribution, myocardial supply, and histologic features of the normal coronary artery. Key words: coronary artery, coronary ostium, high takeoff position Epicardial Coronary Artery SystemThe epicardial coronary artery system consists of the left and right coronary arteries, which normally arise from 0s-tia located in the left and right sinuses of Valsalva, respec- tively ( Fig. 1). In about 50% of humans a "third coronary artery" ("conus artery") arises from a separate ostium in the right sinus. Additional smaller ostia may be found in the right sinus, which give rise to multiple right ventricular branches (Fig. 2). Up to five separate coronary ostia have been described (Figs. 2+.3 The left main coronary artery ranges in length from 1-25 mm before bifurcating into the left anterior descending and left circumflex bran~hes.~ The left anterior descending coronary artery measures from 10-13 cm in length, whereas the usual nondominant left circumflex artery measures about 6-8 cm in length. The usual dominant right coronary artery (supplying posterior descending and/or atrioventricular nodal artery) is about 12-14 cm in length before giving rise to the posterior descending artery. The luminal diameters of the major coronary arteries in adults range as follows: left main, 2.0-5.5 mm (mean 4 mm); left anterior descending, 2.0-5.0 mm (mean 3.6 mm); left circumflex, 1.5-5.5 mm (mean 3.0 mm); and right, 1.5-5.5 mm (mean 3.2 mm)? Although the left anterior descending and left circumflex arteries generally taper in diameter as each extends from the left main bifurcation, the right coronary artery maintains a fairly constant diameter until just before the origin of its posterior descending branch. The subepicardial coronary arteries run on the surface of the heart embedded in various amounts of subepicardial fat. Portions of the epicardial coronary arteries may dip into the myocardium ("mural artery" or "tunneled artery") and be covered for a variable length (1 to several mm)5 by ventricular muscle ("myocardial bridge") ( Coronary OstiaThe left and right coronary ostia arise normally within the sinus of Valsalva or at the junction of the sinus and tub-

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