Atherosclerotic lesions of the gastroepiploic artery: One case requiring postoperative dilation and some interesting postmortem observations

Carrel, Thierry; Ammann, F. W.; Schneider, Jakob; Domeisen, Hannes; Turina, Marko

doi:10.1016/s0022-5223(95)70044-7

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…While the prevalence of atherosclerosis of the RGEA has not been widely investigated [10], Suma et al [11] have reported that one RGEA out of 35 (3%) showed overt atherosclerosis, and three RGEAs out of 35 (9%) showed luminal narrowing between 25 and 50% by pathologic examination. Also, Carrel et al [12] reported that four of 37 patients (10.8%) were found to have RGEA stenosis of greater than 50% by postmortem examination. Our study results showed a somewhat higher incidence of atherosclerosis of the RGEA compared with the incidence of overt atherosclerosis of RGEA reported by Suma et al [11] (3 vs. 10.1%), but showed incidence of stenosis greater than 50% results to those reported by Carrel et al [12].…”

Section: Discussionmentioning

confidence: 98%

“…Also, Carrel et al [12] reported that four of 37 patients (10.8%) were found to have RGEA stenosis of greater than 50% by postmortem examination. Our study results showed a somewhat higher incidence of atherosclerosis of the RGEA compared with the incidence of overt atherosclerosis of RGEA reported by Suma et al [11] (3 vs. 10.1%), but showed incidence of stenosis greater than 50% results to those reported by Carrel et al [12]. These differences might be explained by different study population numbers, different evaluation methods of RGEA atherosclerosis, and different study populations.…”

Section: Discussionmentioning

confidence: 98%

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Availability of the right gastroepiploic artery for coronary artery bypass grafting: preoperative multidetector CT evaluation

Lee

Kim

et al. 2010

Int J Cardiovasc Imaging

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To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) angiography for prediction of availability of the right gastroepiploic artery (RGEA) for coronary artery bypass grafting surgery (CABG). This study included 149 patients who underwent both preoperative MDCT angiography and exploratory laparotomy to harvest the RGEA for CABG. The prediction of availability of RGEA using the MDCT finding was evaluated by comparing it to an exploratory laparotomy evaluation of RGEA as a gold standard. The MDCT findings of atherosclerosis and diameter of the RGEA were analyzed. The atherosclerosis of other visceral branches was also analyzed for the detection of affecting factors to the availability for CABG. Atherosclerotic change of vessel was defined as findings including vessel wall calcification, luminal irregularity, aneurysmal change, and apparent atheroma. For statistical analysis, unpaired t-test and receiver operating curve analyses were used to compare the size of the RGEA, and the chi-square test was used to evaluate significant determinant factors of RGEA availability. In exploratory laparotomy, 21 out of 149 RGEAs were classified as inappropriate as a graft for CABG. The reason for inappropriateness was atherosclerosis of RGEA in 15 patients and small diameter in six patients. Sensitivity, specificity, positive predictive value and negative predictive value of MDCT angiography for assessing RGEA atherosclerosis was 60, 99.6, 94.7 and 96.1%, respectively. Atherosclerotic change of the RGEA itself was the only significant determinant factor for predicting the appropriateness of each RGEA. The mean diameter was 1.94 mm in 21 inappropriate RGEAs and 2.41 mm in 128 appropriate RGEAs. This difference was significant (P = 0.001). The least diameter of appropriate RGEA was 1.4 mm on MDCT angiography, and the cut-off value determined by ROC analysis was 1.8 mm with 82.8% of sensitivity and 61.9% of specificity for inappropriate RGEA, and the area under the curve value was 0.729. MDCT is useful preoperative evaluation tool for RGEA availability. Findings of atherosclerosis of the RGEA and a small diameter on MDCT angiography suggest inappropriateness of the RGEA for CABG surgery.

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