Ueyama K, Watanabe G, Kotoh K, Abe Y, Misaki T
First Department of Surgery, Toyama Medical and Pharmaceutical University, Toyama, Japan
Int J Angiol. 1998 Aug;7(4):317-9. doi: 10.1007/BF01623872.
To evaluate the usefulness of the radial artery (RA) as a graft material for coronary artery bypass grafting (CABG), histologic studies of the RA were performed and compared with the internal thoracic artery (ITA). Specimens were obtained from both ends of 12 RAs and the distal side of the ITA during the operation. The degree of arteriosclerosis was evaluated using an NIH Image 1.57 system. The pathological index of arterioslerotic change was expressed as the ratio of cross-section (Rx: internal luminal area/tunica media area). The mean arteriosclerotic ratio (Rx) of the 12 proximal sides of the RA specimens was 0.18 +/- 0.03, the 12 distal sides 0.27 +/- 0.17, and the 12 ITAs was 0.14 +/- 0.05, respectively. There was significant difference between the distal side of the RA and the ITA. The distal side of the RA was a little greater than the proximal, but there was no significant difference between the proximal side of the RA and the ITA. From the microscopic findings, the tunica media of the RA is poor in elastic fibers and rich in smooth muscle cells compared with the ITA. The internal elastic lumina of the RA is developed as well as the ITA, but more calcification was found in the distal RA than in the others. According to these results, although care must be taken for arteriosclerosis of the distal RA, it can be expected to be a suitable bypass material for CABG.
为评估桡动脉(RA)作为冠状动脉旁路移植术(CABG)移植物材料的效用,对桡动脉进行了组织学研究,并与胸廓内动脉(ITA)进行比较。在手术过程中从12条桡动脉的两端以及胸廓内动脉的远端获取标本。使用美国国立卫生研究院(NIH)Image 1.57系统评估动脉硬化程度。动脉硬化改变的病理指数用横截面积比值表示(Rx:管腔面积/中膜面积)。桡动脉标本12个近端的平均动脉硬化比值(Rx)为0.18±0.03,12个远端为0.27±0.17,12条胸廓内动脉为0.14±0.05。桡动脉远端与胸廓内动脉之间存在显著差异。桡动脉远端略大于近端,但桡动脉近端与胸廓内动脉之间无显著差异。从显微镜检查结果来看,与胸廓内动脉相比,桡动脉的中膜弹性纤维较少,平滑肌细胞较多。桡动脉的内弹性膜与胸廓内动脉一样发达,但桡动脉远端的钙化比其他部位更多。根据这些结果,尽管必须注意桡动脉远端的动脉硬化,但它有望成为冠状动脉旁路移植术合适的旁路材料。