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صفحه اصلي > مقالات علمي > مقالات صفحه 1 > Extraluminal atherosclerosis  

Extraluminal Atherosclerosis: An Under-recognised Finding in Human Aortocoronary Venous Bypass Grafts


Mihan Pourabdollah, MDa,b, Seyed-Ahmad Hasssantash, MDd,e, Behnood Bikdeli, MDc,d,e,g,∗, Maryam Sadeghian, MDd, Haleh Afshar, MDd, Shadi Kalantarian, MD, MPHd,h, Shahram Sabeti, MDf, Hossein Ahmadi, MDi, Mehrab Marzban, MDi and Foroozan Mohammadi, MDc
a Pediatric Respiratory Diseases Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
b Chronic Respiratory Diseases Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
c Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
d Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
e Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
f Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
g Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
h Harvard School of Public Health, Boston, MA, United States
i Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

Background: Coronary artery bypass grafting (CABG) is commonly compromised by graft atherosclerosis. Histopathologic studies confirm various forms of atherosclerosis, including positively remodelled lesions in native coronary arteries but there are no histopathologic reports of extraluminal atherosclerosis in vein grafts
Methods: We prospectively investigated the histopathologic presence and pattern of extraluminal atherosclerosis in human old vein grafts in a two-year interval among patients undergoing redo-CABG at three university hospitals in Tehran. We separately documented clinical and angiographic findings


Results: We evaluated 100 segments from 20 human old vein grafts obtained during the redo CABG. All but four segments demonstrated some degrees of luminal narrowing. Luminal atherosclerotic plaques were detectable in 61 segments. We detected extraluminal atheroscleoris in seven segments. Mean vessel wall thickness was greater in segments containing extraluminal plaques (1.41±0.26mm versus 0.91±0.04mm, P = 0.008). Angiographic findings had a modest correlation with presence or absence of luminal atheromatous lesions (Spearman’s rho: 0.331, P = 0.007). Angiographic degree of stenosis could not predict the presence of positively remodelled atherosclerotic plaques. Spearman’s rho:-2.21,P=0.073


Conclusion: Previous studies suggested positive remodelling in vein grafts. Out study provides histopathologic evidence on extraluminal atherosclerosis in human aortocoronary vein grafts

Download ZIP Download PDF                                         Heart, Lung and Circulation 2013;22:19–24

 

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