TITLE:
Histopathology and Morphometric Analysis of the Internal Mammary Artery to Study the Incidence of Atherosclerosis and Its Associated Risk Factors
AUTHORS:
Shilpa Suresh, S. R. Kalpana, H. V. Jayanth Kumar, Sumithra Selvam, Kumsi Sreedhar
KEYWORDS:
Atherosclerosis, Calcification, Coronary Artery Bypass Graft, Intimal Hyperplasia
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.10 No.6,
June
16,
2020
ABSTRACT: Background: The left internal mammary
artery (IMA) is widely used as a conduit for coronary revascularization. The
incidence of atherosclerosis is known to be lower in the IMA than in the
coronary artery. The aim of this study was to evaluate the reliability of the
use of the distal section of the IMA as an anastomotic site for bypass grafting
and morphometric studies of IMA in patients with proven coronary artery disease
and their associated risk factors. Methods: Patients who underwent
Coronary Artery Bypass Graft (CABG) from June 2010 to November 2012 were chosen
in this retrospective study and the discarded distal segments of the internal mammary
artery were analyzed. The potential risk factors for atherosclerosis considered
were age, sex, diabetes mellitus, history of cigarette smoking, hypertension
and hypercholesterolemia. The samples were analyzed for the degree of intimal
thickening and atherosclerosis by calculating the percentage of Luminal
Narrowing, Intimal Thickness Index (ITI) and Intima-to-Media Ratio (IMR). Results: There were seven cases of intimal hyperplasia and two cases of focal medial
and intimal hyperplasia with fatty streak and no cases of atherosclerosis and
medial calcification. ITI was higher in males when compared to females. There
was a strong relationship between IMR and smokers when compared to nonsmokers. Conclusion: In our study, when ITI was used as the dependent variable, diabetes was the
most important factor. When IMR was used, the strongest predictor was
hypercholesterolemia. There was a strong relationship between IMR and smokers
when compared to nonsmokers.