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Morphological differences of the internal thoracic artery in patients with and without coronary artery

R Marx1, T W Jax, G Plehn

  • 1Heart Center Wuppertal, Department of Cardiology, University of Witten-Herdecke, Wuppertal, Germany. marxr@uni-duesseldorf.de

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|September 28, 2001
PubMed

Insights

The internal thoracic artery shows no morphological changes in patients with coronary artery disease, unlike the common carotid artery. This suggests the internal thoracic artery is protected from atherosclerosis, supporting its use in coronary artery bypass grafting.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Medical Imaging

Background:

  • The internal thoracic artery (ITA) is a preferred arterial graft for myocardial revascularisation due to superior patency rates compared to venous grafts.
  • Morphological differences in the ITA between patients with and without coronary artery disease (CAD) have not been previously investigated.
  • Comparison of ITA morphology with the common carotid artery (CCA) in the context of CAD is lacking.

Purpose of the Study:

  • To investigate morphological differences in the internal thoracic artery (ITA) between patients with and without coronary artery disease (CAD).
  • To compare the intima-media thickness of the ITA with that of the common carotid artery (CCA) in patients with and without CAD.
  • To assess the protective influence of atherosclerosis on the ITA.

Main Methods:

  • Non-invasive ultrasound assessment of the internal thoracic artery (ITA) and common carotid artery (CCA) in 24 patients (12 with CAD, 12 without CAD).
  • Measurement of intima-media thickness (IMT) and vessel diameter for both arteries.
  • Comparative analysis of IMT between the ITA and CCA in relation to CAD status.

Main Results:

  • Intima-media thickness (IMT) of the ITA was comparable in patients with and without CAD (0.51±0.11 mm vs. 0.50±0.17 mm, P>0.05).
  • Intima-media thickness (IMT) of the common carotid artery (CCA) was significantly greater in patients with CAD (0.84±0.13 mm vs. 0.73±0.07 mm, P≤0.014).
  • No significant correlation was found between the IMT of the ITA and CCA (r=0.018, P>0.05).

Conclusions:

  • The intima-media complex of the internal thoracic artery (ITA) is protected from the influence of atherosclerosis, as demonstrated by non-invasive ultrasound.
  • Morphological differences, specifically intima-media thickness, were not observed in the ITA of patients with coronary artery disease compared to those without.
  • These findings support the continued widespread use of the ITA as a reliable coronary artery bypass graft due to its inherent resistance to arteriosclerotic changes.
Abstract

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