title: Histomorphologic superiority of internal thoracic arteries over right gastroepiploic arteries for coronary bypass.
abstract: OBJECTIVE
  In this study, we compared the histologic and morphometric properties of both internal thoracic arteries and the right gastroepiploic artery (GEA) in patients undergoing coronary artery bypass grafting (CABG).
  
  
  METHODS
  We microscopically examined transverse sections of segments of both internal thoracic arteries and the right GEA obtained from 83 consecutive patients who underwent CABG.
  
  
  RESULTS
  There were no significant differences between the internal thoracic arteries. Significant differences were found between the left and right internal thoracic arteries and GEA in the intimal width (21.8, 21.5, and 71.7 μm, respectively; P < .01), intima-to-media ratio (0.286, 0.256, and 0.749, respectively; P < .01), and media width (148.5, 157.5, and 164.8 μm, respectively; P = .43). No atherosclerotic lesions, medial calcification, or intimal thickening were seen in the internal thoracic arteries; however, atherosclerotic lesions were seen in the GEA. The intima of the GEA was thicker than that of the internal thoracic arteries. Intimal thickening of the GEA, but not the internal thoracic arteries, was positively correlated with risk of arteriosclerosis. In patients with diabetes mellitus, dietary/drug therapy and insulin therapy were associated with GEA intimal thickness (P = .02 and .01, respectively).
  
  
  CONCLUSIONS
  The internal thoracic arteries have equivalent histologic and morphometric properties that differ from those of the GEA only in intimal width. The former had no intimal thickening, and is thus preferable to the GEA for CABG.
authors.affiliation: Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan. Electronic address: t.nakajima@sapmed.ac.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakajima
authors.affiliation: Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Tachibana
authors.affiliation: Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takagi
authors.affiliation: Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Kawaharada
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000473:pathology*; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D024405:Gastroepiploic Artery / Q000473:pathology / Q000637:transplantation*; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008323:Mammary Arteries / Q000473:pathology / Q000637:transplantation*; D011183:Postoperative Complications / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology
keywords: coronary artery bypass grafting; gastroepiploic artery; internal thoracic artery; intimal hyperplasia