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肋间动脉:评估其作为冠状动脉搭桥移植物适用性的组织形态计量学研究。

Intercostal artery: histomorphometric study to assess its suitability as a coronary bypass graft.

作者信息

van Son J A, Smedts F, Korving J, Guyt A, de Kok L B

机构信息

Department of Pathology, Diagnostic Center SSDZ, Delft, The Netherlands.

出版信息

Ann Thorac Surg. 1993 Nov;56(5):1078-81. doi: 10.1016/0003-4975(95)90018-7.

Abstract

To assess potential suitability of the intercostal artery as a conduit in myocardial revascularization a histomorphometric study of the fifth intercostal artery (n = 11) and intercostal arteries other than the fifth (n = 9) was conducted. All arteries were harvested at autopsy in 11 individuals (mean age, 75 years). The length of the intercostal arteries varied from 22 to 35 cm (mean, 29.4 cm). Three combinations of histologic patterns were seen along the course of the intercostal artery: a proximal elastic segment followed by subsequent elastomuscular and muscular segments (n = 3), a proximal elastomuscular segment with the remainder of the artery being muscular (n = 6), and a completely muscular pattern (n = 2). The mean luminal diameter of the fifth intercostal arteries varied from 1.4 +/- 0.3 mm at the origin to 0.9 +/- 0.2 mm at 30 cm (30% to 40% decrease in diameter due to the flaccid state and rigor mortis). The mean intimal thickness at these locations was 54 +/- 38 microns and 25 +/- 16 microns and the mean thickness of the media was 205 +/- 38 microns and 70 +/- 45 microns. The histologic findings, mean luminal diameter, and mean diameter of the intima and the media were similar in the intercostal arteries other than the fifth. Our study demonstrates that the intercostal artery has a relatively thin intima and media, the latter being elastic or elastomuscular in the proximal segment in the majority of the investigated arteries, which are favorable properties with regard to its potential suitability as a coronary bypass conduit.

摘要

为评估肋间动脉作为心肌血运重建管道的潜在适用性,我们对11条第五肋间动脉和9条非第五肋间动脉进行了组织形态计量学研究。所有动脉均取自11例个体(平均年龄75岁)的尸检样本。肋间动脉长度在22至35厘米之间(平均29.4厘米)。沿肋间动脉走行可见三种组织学模式组合:近端弹性段后接弹性肌性段和肌性段(n = 3);近端弹性肌性段,其余为肌性段(n = 6);完全肌性模式(n = 2)。第五肋间动脉的平均管腔直径从起始处的1.4±0.3毫米变化至30厘米处的0.9±0.2毫米(由于尸僵和松弛状态,直径减少30%至40%)。这些位置的平均内膜厚度分别为54±38微米和25±16微米,中膜平均厚度分别为205±38微米和70±45微米。非第五肋间动脉的组织学表现、平均管腔直径以及内膜和中膜的平均直径与之相似。我们的研究表明,肋间动脉内膜和中膜相对较薄,在大多数被研究动脉的近端,中膜为弹性或弹性肌性,就其作为冠状动脉搭桥管道的潜在适用性而言,这些都是有利特性。

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