“Thinning-Down Phenomenon” and vasomotor adaptability of the inferior epigastric artery graft

Double Supply to Left Anterior Descending Artery by Additional Saphenous Vein Graft in Internal Thoracic Artery Malperfusion Syndrome

“…Important vasoconstrictor substances, which may be spasmogens for blood vessels, are endothelium‐derived contracting factors such as endothelin, thromboxane A 2 , prostaglandin F 2 α, circulating sympathomimetic substances (α—adrenoceptor agonist) such as norporepinefrine, platelet‐derived such as 5‐hydroxytryptamine, substances released from mast cell and basophils such as histamine, muscarinic receptor agonist such as acetylcholine, renin‐angiotensin system‐related substances such as angiotensin, and depolarizing agents such as potassium ion. These vasoconstrictor substances may be important in the nature of vasoconstriction in arterial grafts 11,12 …”

“…These vasoconstrictor substances may be important in the nature of vasoconstriction in arterial grafts. 11,12 Severe proximal stenosis of the LAD in the presence of a distal artery of good quality (diameter≥2 mm) supplying a large area of normally contracting myocardium, severe ventricular hypertrophy, sequential ITA grafts, use of the terminal part of the ITA, and replacement of a patent saphenous vein graft to the LAD by a new ITA graft have been suggested as risk factors for ITA malperfusion syndrome. 7,8 The time interval to perform an additional saphenous vein graft to distal LAD plays a crucial role for patient outcome.…”

Inferior Epigastric Artery Grafting: Clinical Results

“…24.1). This "thinningdown phenomenon" has been observed by others [15,22,23]. Such a phenomenon is thought to be an adaptive response to a decrease in IEA flow secondary to a competitive flow through the native coronary vessel.…”

“…Such a phenomenon is thought to be an adaptive response to a decrease in IEA flow secondary to a competitive flow through the native coronary vessel. Rona et al [23] demonstrated dilation of a string-like IEA graft during rapid induced atrial pacing or nitroglycerin injection. Furthermore, Buche et al [22] showed reversal of an angiographically narrowed IEA graft on a control study in which the stenosis on the bypassed coronary vessel had significantly increased.…”