The physiologic and histologic properties of the distal internal thoracic artery and its subdivisions

Sahar, Gideon; Shavit, Reut; Yosibash, Zohar; Novack, Lena; Matsa, Menachem; Medalion, Benjamin; Hochhauser, Edith; Aravot, Dan

doi:10.1016/j.jtcvs.2014.12.028

Cited by 11 publications

(4 citation statements)

References 33 publications

(45 reference statements)

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“…Lastly, the flow rates of the distal IMA and its branches (the superior epigastric and musculophrenic arteries) were studied by Sahar et al 23) The subdivisions were significantly more reactive to norepinephrine than the distal internal thoracic artery, suggesting caution in the use of bifurcation for revascularization.…”

Section: Resultsmentioning

confidence: 99%

Up-to-Date, Skeletonized or Pedicle Bilateral Internal Mammary Artery; Does It Matter?

Parissis

2023

ATCS

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In this article, we reported on the up-to-date literature regarding skeletonized bilateral internal mammary artery (BIMA) flow and the effect on sternal perfusion. We also reviewed the pros and cons of the skeletonization technique versus the conventional pedicle technique for harvesting the BIMA. Methods: We performed an up-to-date review using the PubMed database, with a specific focus on the contemporary published literature. Results: BIMA skeletonization can preserve the sternal microcirculation, minimize tissue damage, and maintain blood supply to the chest wall at the tissue level. This effect is also apparent in diabetics. Deep sternal wound infection (DSWI) rates are significantly less with skeletonization versus the conventional pedicle technique and are comparable to single internal mammary artery harvesting. Conclusions: Contemporary large-scale studies demonstrate that skeletonization of the BIMA increases conduit length, provides superior flow, reduces the incidence of DSWIs, and improves late survival. Hopefully, this review will increase awareness of the compelling evidence in favor of using skeletonized internal mammary arteries and stimulate increased uptake of BIMA revascularization surgery.

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Section: Resultsmentioning

confidence: 99%

Up-to-Date, Skeletonized or Pedicle Bilateral Internal Mammary Artery; Does It Matter?

Parissis

2023

ATCS

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“…The ITA composition has been characterized as an elastic and musculoelastic artery, depending on the relative distance from the heart. 27,40,41 Heterogeneous distribution of elastin and collagen fibers influences the vascular wall mechanics and highlights the importance of donor tissue selectivity. 9,27 Histomechanical similarities exist between the ITA and the left anterior descending artery (LAD), with both arteries exhibiting similar compliance and a higher amount of elastin than other common autograft tissue sources.…”

Section: Discussionmentioning

confidence: 99%

“…The ITA composition has been characterized as an elastic and musculoelastic artery, depending on the relative distance from the heart 27,40,41 . Heterogeneous distribution of elastin and collagen fibers influences the vascular wall mechanics and highlights the importance of donor tissue selectivity 9,27 .…”

Section: Discussionmentioning

confidence: 99%

Small‐diameter artery decellularization: Effects of anionic detergent concentration and treatment duration on porcine internal thoracic arteries

et al. 2021

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Engineered replacement materials have tremendous potential for vascular applications where over 400,000 damaged and diseased blood vessels are replaced annually in the United States alone. Unlike large diameter blood vessels, which are effectively replaced by synthetic materials, prosthetic small-diameter vessels are prone to early failure, restenosis, and reintervention surgery. We investigated the differential response of varying 0%-6% sodium dodecyl sulfate and sodium deoxycholate anionic detergent concentrations after 24 and 72 h in the presence of DNase using biochemical, histological, and biaxial mechanical analyses to optimize the decellularization process for xenogeneic vascular tissue sources, specifically the porcine internal thoracic artery (ITA). Detergent concentrations greater than 1% were successful at removing cytoplasmic and cell surface proteins but not DNA content after 24 h. A progressive increase in porosity and decrease in glycosaminoglycan (GAG) content was observed with detergent concentration. Augmented porosity was likely due to the removal of both cells and GAGs and could influence recellularization strategies. The treatment duration on the other hand, significantly improved decellularization by reducing DNA content to trace amounts after 72 h. Prolonged treatment times reduced laminin content and influenced the vessel's mechanical behavior in terms of altered circumferential stress and stretch while further increasing porosity. Collectively, DNase with 1% detergent for 72 h provided an effective and efficient decellularization strategy to be employed in the preparation of porcine ITAs as bypass graft scaffolding materials with minor biomechanical and histological penalties.

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“…Several histomorphometric parameters have been reported in the literature, namely: maximal intimal width (IW), medial width at maximal intimal width (MW), intimal and medial areas and others [6]. Additional parameters may be calculated from these primary parameters, particularly intima/media ratio (IMR), which has been suggested as the most sensitive method for grading atherosclerosis and intimal hyperplasia [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Histomorphometric analysis of the human internal thoracic artery and relationship with cardiovascular risk factors

Fonseca

Antunes

et al. 2019

PLoS ONE

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In this study, we aimed at performing a histomorphometric analysis of human left internal thoracic artery (ITA) samples as well as at correlating the histomorphometric findings with the clinical profile, including risk factors and medication. Distal segments of ITA were obtained from 54 patients undergoing coronary artery bypass grafting. Histological observation was performed in paraffin-embedded transverse sections of ITA through four staining protocols: hematoxylin-eosin, van Gieson, Masson’s trichrome and von Kossa. Morphometric analysis included the intimal width (IW), medial width (MW) and intima/media ratio (IMR). No overt atherosclerotic lesions were observed. Mild calcifications were observed across the vascular wall layers in almost all samples. Multivariable linear regression analysis showed associations between IW and IMR and the following clinical variables: age, gender, kidney function expressed as eGFR and myocardial infarction history. Age (odds ratio = 1.16, P = 0.004), female gender (odds ratio = 11.34, P = 0.011), eGFR (odds ratio = 1.03, P = 0.059) and myocardial infarction history (odds ratio = 4.81, P = 0.040) were identified as the main clinical predictors for intimal hyperplasia. Preatherosclerotic lesions in ITA samples from patients undergoing coronary revascularization were associated not only with classical cardiovascular risk factors such as age and gender, but also with other clinical variables, namely kidney function and myocardial infarction history.

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The physiologic and histologic properties of the distal internal thoracic artery and its subdivisions

Cited by 11 publications

References 33 publications

Up-to-Date, Skeletonized or Pedicle Bilateral Internal Mammary Artery; Does It Matter?

Up-to-Date, Skeletonized or Pedicle Bilateral Internal Mammary Artery; Does It Matter?

Small‐diameter artery decellularization: Effects of anionic detergent concentration and treatment duration on porcine internal thoracic arteries

Histomorphometric analysis of the human internal thoracic artery and relationship with cardiovascular risk factors

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