Morphological differences of the internal thoracic artery in patients withand without coronary artery disease - evaluation by duplex-scanning

Objective: The internal thoracic artery is an established arterial graft fo r myocardial revascularisation, especially of the left anterior descending artery because of a higher patency rate compared to venous grafts. It has n ever been investigated, whether there are morphological differences in this vessel between patients with or without coronary artery disease or if they are comparable to morphological changes in the common carotid artery. Meth ods: We investigated the internal thoracic artery and the common carotid ar tery of 24 patients (12 with coronary artery disease, 12 without coronary a rtery disease) with an ultrasonic system on both sides. The intima-media th ickness and the diameter of both vessels were estimated. Results: The intim a-media-thickness of the internal thoracic artery was comparable in all pat ients, independent of the presence of a coronary artery disease (0.51 +/- 0 .11 mm with coronary artery disease, 0.50 +/- 0.17 mm without coronary arte ry disease, P > 0.05), Compared with this the intima-media-thickness of the common carotid artery was thicker in patients with coronary artery disease (0.84 +/- 0.13 mm with coronary artery disease, 0.73 +/- 0.07 mm without c oronary artery disease, P less than or equal to 0.014). There was no correl ation between the thickness of the internal thoracic artery and the common carotid artery (r = 0.018, P > 0.05). Conclusions: It could be demonstrated for the first with non-invasive ultrasound, that the intima-media-complex of the internal thoracic artery is protected of the influence of arterioscl erosis. There are no morphological differences like the intima-media-thickn ess of the common carotid artery. The proven protective mechanism underline s the widespread use of the internal thoracic artery as a coronary artery b ypass graft. (C) 2001 Elsevier Science B.V. All rights reserved.