Document Detail


Morphometric study of the right gastroepiploic and inferior epigastric arteries.
MedLine Citation:
PMID:  9066389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Based on earlier observations that the thickness of the intima and structure of the media may have an impact on the long-term patency of arterial conduits and the lack of detailed histologic studies of the right gastroepiploic and inferior epigastric arteries, we subjected both vessels to morphometric analysis with emphasis on their suitability as conduits in myocardial revascularization. METHODS: The right gastroepiploic and inferior epigastric arteries were harvested from 28 unselected individuals (mean age, 73.2 years) at autopsy, and the luminal diameter and the width of the intima and media were measured. RESULTS: At all levels of measurement (origin, 10 cm, and 15 cm), the luminal diameter of the inferior epigastric artery was significantly smaller than that of the right gastroepiploic artery (p < 0.05). The right gastroepiploic artery demonstrated only mild intimal hyperplasia. In contrast, the inferior epigastric artery showed substantial intimal hyperplasia within the first 1-cm segment (mean, 134 +/- 131 microns versus 50 +/- 49 microns for the corresponding segment of the right gastroepiploic artery; p = 0.01). Intimal hyperplasia was only mild in the remainder of the inferior epigastric artery. In both vessels, the media was muscular with rare dispersed elastic fibers. The mean thickness of the media ranged from 380 +/- 116 microns proximally to 155 +/- 70 microns distally for the right gastroepiploic artery, and from 316 +/- 86 to 165 +/- 70 microns, respectively, for the inferior epigastric artery. CONCLUSIONS: In myocardial revascularization, use of the right gastroepiploic artery may generally be preferable to use of the inferior epigastric artery. This recommendation is based on the larger luminal diameter of the right gastroepiploic artery as compared with the inferior epigastric artery, the significantly greater intimal hyperplasia in the first segment of the inferior epigastric artery, and the limitation that the inferior epigastric artery can be used only as a free graft. The rate of development of intimal hyperplasia in the right gastroepiploic artery, if used as an in situ coronary artery bypass graft, may be slow, approximating that of the right gastroepiploic artery in its natural environment.
Authors:
J A van Son; F M Smedts; C Q Yang; M Mravunac; V Falk; F W Mohr; G W He
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  63     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-08     Completed Date:  1997-04-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  709-15     Citation Subset:  AIM; IM    
Affiliation:
Herzzentrum, University of Leipzig, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arteries / anatomy & histology
Epigastric Arteries / anatomy & histology*
Female
Humans
Hyperplasia
Male
Myocardial Revascularization
Stomach / blood supply*
Tunica Intima / cytology
Tunica Media / cytology
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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