Method for the morphometric analysis of arterial structure

Morphometric analysis of coronary artery stenosis: an accuracy and reliability study

Luminal narrowing was assessed in 238 transverse segments obtained from coronary arteries removed at postmortem. In each segment, narrowing was assessed by gross visual estimation before and after fixation, and on histological sections by stereological point counting and computer-assisted planimetry. Computer-assisted planimetry was found to be accurate and reliable but the equipment needed is expensive, and requires specialized software and an experienced user. Morphometric measurement by stereologic point counting was accurate, rapid, simple, and inexpensive. In comparison with computer-assisted planimetry visual estimation was found to be neither accurate nor reliable. Our results indicate point counting as the method of choice for assessment of coronary artery luminal narrowing by atherosclerosis.

The caliber persistent artery of the stomach: a unifying approach to gastric aneurysm, Dieulafoy's lesion, and submucosal arterial malformation

The caliber persistent artery of the stomach is the most dangerous form of gastrorrhagias; the overall lethality rate is 60.5%. A literature review aimed at completeness, a study of the hitherto largest case material (24 cases), and a comparative analysis of the bleeding and normal gastric arteries gave the following results: (1) the walls of the pathologic arteries are of normal structure; (2) as submucous arteries, they are of normal diameter; (3) they are attached to the mucosa by virtue of Wanke's musculoelastic mantle; (4) at the level of the muscularis mucosae, they are definitely oversized; (5) in the area of the linkage of the artery to the mucosa, a vulnerable mucosal spot is created; (6) the artery is accompanied by a vein of similar caliber; and (7) perforation of the vein takes place before that of the artery. In addition to surgical pathology and pathogenesis, the pitfalls of its diagnosis and treatment are also discussed. Caliber persistent artery of the stomach is much more common than the literature indicates, necessitating an increased awareness of the condition.

State of the vein grafts, native coronary arteries, and myocardium and principal cause of death in patients dying after aortocoronary bypass grafting

Fifty five patients with 108 coronary bypass saphenous vein grafts were studied at necropsy. The mean duration of the grafts was 153 days (SD 516). The luminal narrowing of the native coronary arteries proximal to, at, and distal to the vein graft anastomoses and the narrowing of the non-grafted arteries were evaluated planimetrically. Twenty nine per cent of coronary arteries distal to graft anastomoses showed at least 76% narrowing and 50-75% occlusion was seen in 39% of such arteries. Fifty three per cent of non-grafted arteries showed at least 76% luminal narrowing and 26% had 50-75% narrowing. Six patients (11%) had surgically induced dissection of coronary arteries. Seventy seven vein grafts (71%) showed no appreciable luminal narrowing. Problems related to operative technique caused 30% of the deaths.