Jülke M, von Segesser L, Schneider J, Turina M, Heitz P U
Institut für Pathologie, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1989 Sep 9;119(36):1219-23.
In the last ten years the internal mammary artery (IMA) has, thanks to its higher patency rate, been increasingly used for revascularization of the coronary arteries in preference to the saphenous vein. However, uncertainty about atherosclerosis in the IMA has continued to be voiced, and to clarify the issue we investigated post mortem the IMA and left anterior descending (LAD) coronary artery in 48 male patients who died aged 45-75 years. Six segments of the IMA and 4 of the LAD, totalling 465 histologic cross sections, were estimated quantitatively. The result was unequivocal: the tendency to stenosing intimal sclerosis is much more marked in the coronary artery than in the IMA. The IMA is not immune to intimal thickening, but even in patients with severe coronary artery disease the degree of atherosclerosis in the IMA is not of functional relevance. This fact makes the IMA the vessel of choice for coronary bypass surgery.
在过去十年中,由于其较高的通畅率,乳内动脉(IMA)越来越多地被用于冠状动脉血运重建,而不是大隐静脉。然而,关于IMA中动脉粥样硬化的不确定性一直存在,为了澄清这个问题,我们对48例年龄在45至75岁之间死亡的男性患者的IMA和左前降支(LAD)冠状动脉进行了尸检研究。对IMA的六个节段和LAD的四个节段,共465个组织学横截面进行了定量评估。结果是明确的:冠状动脉中内膜硬化狭窄的倾向比IMA中更为明显。IMA并非不受内膜增厚的影响,但即使在患有严重冠状动脉疾病的患者中,IMA中的动脉粥样硬化程度也不具有功能相关性。这一事实使得IMA成为冠状动脉搭桥手术的首选血管。