title: [Comparative study on the ultrastructure of radial artery in elderly patients underwent coronary artery bypass grafting with diabetes mellitus].
abstract: OBJECTIVE
  To explore the impact of age and diabetes mellitus (DM) on the ultrastructure of radial artery (RA).
  
  
  METHODS
  From June 2009 to December 2010, 64 patients underwent coronary artery bypass grafting (CABG) with autologous RA: 14 patients aged beyond 65 years without DM [9 male patients and 5 female patients, age (70 ± 4) years] and 18 patients aged beyond 65 years with DM [11 male patients and 7 female patients, age (68 ± 5) years], 20 patients aged under 60 years without DM [13 male patients and 7 female patients, age (53 ± 5) years] and 12 patients aged under 60 years with DM [7 male patients and 5 female patients, age (51 ± 6) years]. Four groups were subjected to routine electron microscopic examination and transmission electron microscopic examination.
  
  
  RESULTS
  There were significant differences in percentage of endothelial denudation among four groups according to scanning electron microscopic evaluation (χ² = 18.082, P = 0.000). To compare with each other, there were significant differences between DM elderly patients and non-DM elderly patients, also between DM young patients and non-DM young patients according to scanning electron microscopic evaluation. There were no significant differences between DM elderly patients and DM young patients, also between non-DM elderly patients and non-DM young patients. Foam cells and the tendency of smooth muscle cells moving to intima could be visualized in DM patients according to transmission electron microscope. According to semiquantitative electron microscopic evaluation, non-DM young patients got the lower total scores than DM young patients (1.32 ± 0.20 vs. 4.38 ± 0.30) while non-DM elderly patients got the lower total scores than DM elderly patients (1.43 ± 0.20 vs. 4.67 ± 0.30). According to factorial design, there were significant differences between DM patients and non-DM patients (F = 41.22, P = 0.000). There were no differences between elderly patients and young patients (F = 1.24, P = 0.270). There is no interaction (F = 1.05, P = 0.309) between age and DM.
  
  
  CONCLUSIONS
  After preoperative assessment with modified Allen's test and Doppler analysis, RA used as graft in the elderly has similar quality and function with young patients, and it may lead to a high patency in long term. However, the quality of RA in patients with DM is in bad condition, and further research on patency needs to be done.
authors.affiliation: Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zou
authors.forename: Xu-jun
authors.initials: XJ
authors.lastname: Chen
authors.forename: Ming
authors.initials: M
authors.lastname: Xu
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.forename: Li-ming
authors.initials: LM
authors.lastname: Wang
authors.forename: Fu-hua
authors.initials: FH
authors.lastname: Huang
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
mesh_terms: D000367:Age Factors; D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000473:pathology* / Q000601:surgery; D003920:Diabetes Mellitus / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000648:ultrastructure*