Histomorphological studies of the distal internal thoracic artery which support its use for coronary artery bypass grafting

Marx, R.; Clahsen, Harald; Schneider, R; Sons, H. U.; Klein, R.M; Gülker, H

doi:10.1016/s0021-9150(01)00483-x

Cited by 27 publications

(22 citation statements)

References 31 publications

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“…In this study, Verhoeff stain revealed that the ITA is an elastic artery, though anatomically, it is considered to be medium‐sized. Similar results have been reported by others 9,10,21,22. The ITA is considered as an elastic artery in the proximal and middle part, whereas only the distal part is considered as muscular artery.…”

Section: Discussionsupporting

confidence: 87%

“…The ITA is considered as an elastic artery in the proximal and middle part, whereas only the distal part is considered as muscular artery. However, Marx et al22 examined the distal part of the ITA in 100 patients and found an elastic type of vessel, but hybrid and muscular patterns of the ITA have also been reported in the literature. In this study, the ITA was dissected between the first and second costal cartilage, which can be considered as being in between the proximal and middle part of the ITA.…”

Section: Discussionmentioning

confidence: 99%

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Histomorphometric and sympathetic innervation of the human internal thoracic artery

Reddy

Kumar

Prasad

2011

Clinics

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INTRODUCTION:Internal thoracic artery (ITA) is an established arterial graft for the coronary artery by‐pass surgery. Special micro‐anatomical features of the ITA wall may protect it from age related pathological changes. One of the complications seen after coronary artery bypass grafting is vasospasm. Sympathetic nerves may be involved in vasospasm.OBJECTIVE:To ascertain the sympathetic innervation of the internal thoracic artery and to assess the effect of aging on this artery by histomorphometry.METHOD:Fifty‐four human internal thoracic artery samples were collected from 27 cadavers (19 male and 8 female) with ages of 19 to 83 years. Samples were divided into three age groups: G1, 19–40 years; G2, 41–60 years; G3, ≥61 years. Sections (thickness 5 µm) of each sample were taken and stained with hematoxylin–eosin and Verhoeff–Van Gieson stains. Five of fifty‐four samples were processed for tyrosine hydroxylase immunostaining.RESULTS:The thickness of the tunica intima was found to be constant in all age groups, whereas the thickness of the tunica media decreased in proportion to age. Verhoeff–Van Gieson staining showed numerous elastic laminae in the tunica media. Significant differences (p<0.0001) in the number of elastic laminae were found between G1 with G2 cadavers, between G2 and G3 cadavers and between G3 and G1 cadavers. Tyrosine hydroxylase immunostaining demonstrated sympathetic fibers, located mainly in the tunica adventitia and the adventitia–media border. The sympathetic nerve fiber area and sympathetic index were found to be 0.0016 mm2 and 0.012, respectively.DISCUSSION:Histology of the ITA showed features of the elastic artery. This may be associated with lower incidence of Atherosclerosis or intimal hyperplasia in ITA samples even in elderly cases. Low sympathetic index (0.012) of ITA may be associated with fewer incidences of sympathetic nervous systems problems (vasospasm) of the ITA.CONCLUSION:Sympathetic nerve fibers are present in the adventitia of the internal thoracic artery. This is an elastic artery, although anatomically it is considered to be medium‐sized. The sympathetic index may be used for analysis of sympathetic nerve fiber‐related problems of the internal thoracic artery.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Histomorphometric and sympathetic innervation of the human internal thoracic artery

Reddy

Kumar

Prasad

2011

Clinics

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“…The ITA is found to be an artery with elastic properties [28,29] that is resistant to atherosclerosis [30,31], although cases of diseased arteries have been reported in the literature [32,33]. This anatomically medium-sized artery receives sympathetic fibers in its adventitia [28] and has routinely been harvested as a suitable conduit for the myocardium ischaemia relief, showing an increased patency compared to the saphenous vein grafts [34].…”

Section: Discussionmentioning

confidence: 99%

Abnormal origin of internal thoracic artery from the thyrocervical trunk: surgical considerations

Paraskevas

Natsis

Tzika

et al. 2012

J Cardiothorac Surg

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An unusual case of left internal thoracic artery (ITA) origin from the thyrocervical trunk (TCT) was detected during routine cadaver dissection. The variability of origin and course of ITA has less or more frequently been documented in the literature. However, the ITA origin from the TCT on the left side has been detected less commonly, making its dissection and preparation during coronary artery bypass grafting surgery more difficult. We discuss the ITA origin and course variability as well as clinical significance of the present variant, reviewing the relative literature. The objective of our study is to exhibit a rare ITA origin in order to provide a more accurate knowledge of such variations.

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“…The elastic predominated in 52% of cases whilst the muscle predominated in 26% and a hybrid pattern in 22%. Thus, even between samples of distal segment of the ITA there is a great histological variability making prior conclusions open to discussion [21].…”

Section: Discussionmentioning

confidence: 99%

<![CDATA[<B>Sequential histomorphometric study of the left internal thoracic artery</B>]]>

Kneubil¹,

Gomes²,

Aquino³

et al. 2006

Braz. j. cardiovasc. surg.

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Objective: The use of left internal thoracic artery (LITA) in coronary artery bypass surgery is currently recognized as the best option, providing lower incidences of cardiovascular events and superior long-term survival. Now, incremental utilization of these grafts makes a reassessment of its histological structure necessary. Therefore, the purpose of this study was to examine and compare the sequential histological structure of LITA.Method: Specimens of LITA harvested from 18 cadavers, divided into nine proportional segments, were studied. Cuts of each segment were stained by the Verhoeff-Van Gieson technique. The following parameters were analyzed: perimeter of the arterial lumen, thickness of the intima, thickness of the media layer, amount of elastic fiber in the media layer and the elastic fiber density.Results: The collected data showed that perimeter of the LITA decreases downstream on its course, the thickness of the intima is increased in the proximal segments, the thickness of the media layer diminishes throughout its extension, the number of elastic fibers is concentrated in the intermediate segments and the density of elastic fibers is reduced in the proximal and distal segments. Conclusion:Therefore, the findings of the present study validate the heterogeneity of the LITA sequential histological structure. Descriptors

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Histomorphological studies of the distal internal thoracic artery which support its use for coronary artery bypass grafting

Cited by 27 publications

References 31 publications

Histomorphometric and sympathetic innervation of the human internal thoracic artery

Histomorphometric and sympathetic innervation of the human internal thoracic artery

Abnormal origin of internal thoracic artery from the thyrocervical trunk: surgical considerations

<![CDATA[<B>Sequential histomorphometric study of the left internal thoracic artery</B>]]>

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