Histological Characterization of the Internal Thoracic Artery as Preferred Conduit for Coronary Bypass

Today the internal thoracic artery (ITA) is the preferred conduit for coronary artery bypass. It has been clinically demonstrated that an arterial conduit fits better with the hemodynamic conditions of an arterial system, where a systemic arterial pressure is present. The recent surgical improvements allow to use a single pedicle of ITA for multiple bypasses. They can be also constructed sequentially, implanting in a T fashion an adequately long segment of ITA on the contralateral pedicle, which acts as unique arterial vascular conduit [1,2]. Being an artery of medium-small caliber, ITA should be expected to be involved by atherosclerotic lesions, especially in elderly patients, that often present other localizations of this disease. However, ITA seems to enjoy of a privileged preservation toward atherosclerosis.