What protects Internal Thoracic Artery from atherosclerosis?
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The internal mammary arteries (IMAs) are commonly used as the conduit to bypass major coronary artery stenosis, and have shown greater long-term patency rates and improved survival as compared to saphenous vein grafts (SVGs).
The internal mammary artery (IMA) grafts have been associated with long-term patency and improved survival as compared to saphenous vein grafts (SVGs).
The superiority of IMAs over SVGs can be attributed to its striking resistance to the development of atherosclerosis. Structurally its endothelial layer shows fewer fenestrations, lower intercellular junction permeability, greater anti-thrombotic molecules such as heparin sulfate and tissue plasminogen activator, and higher endothelial nitric oxide production, which are some of the unique ways that make the IMA impervious to the transfer of lipoproteins, which are responsible for the development of atherosclerosis. A better comprehension of the molecular resistance to the generation of adhesion molecules that are involved in the transfer of inflammatory cells into the arterial wall that also induce smooth muscle cell proliferation is needed. This basic understanding is crucial to championing the use of IMA as the first line of defense for the treatment of coronary artery disease.
The superiority of IMAs over SVGs with less mortality and greater patency rates (>90% at 10 years) could be attributed to the striking resistance of this conduit to atheroma, where multiple structural and physical properties of the IMA could be involved (Table). It is interesting to note that IMA grafting of the LAD is also associated with less progression of native atherosclerotic disease within the proximal LAD as compared to when a vein graft is anastomosed to the LAD, as well as greater and rapid native disease progression from the development of fibrosis and calcification.
The internal mammary arteries (IMAs) are commonly used as the conduit to bypass major coronary artery stenosis, and have shown greater long-term patency rates and improved survival as compared to saphenous vein grafts (SVGs).
The internal mammary artery (IMA) grafts have been associated with long-term patency and improved survival as compared to saphenous vein grafts (SVGs).
The superiority of IMAs over SVGs can be attributed to its striking resistance to the development of atherosclerosis. Structurally its endothelial layer shows fewer fenestrations, lower intercellular junction permeability, greater anti-thrombotic molecules such as heparin sulfate and tissue plasminogen activator, and higher endothelial nitric oxide production, which are some of the unique ways that make the IMA impervious to the transfer of lipoproteins, which are responsible for the development of atherosclerosis. A better comprehension of the molecular resistance to the generation of adhesion molecules that are involved in the transfer of inflammatory cells into the arterial wall that also induce smooth muscle cell proliferation is needed. This basic understanding is crucial to championing the use of IMA as the first line of defense for the treatment of coronary artery disease.
The superiority of IMAs over SVGs with less mortality and greater patency rates (>90% at 10 years) could be attributed to the striking resistance of this conduit to atheroma, where multiple structural and physical properties of the IMA could be involved (Table). It is interesting to note that IMA grafting of the LAD is also associated with less progression of native atherosclerotic disease within the proximal LAD as compared to when a vein graft is anastomosed to the LAD, as well as greater and rapid native disease progression from the development of fibrosis and calcification.
