Parietal centripetal and centrifugal thickening neovascularization
in the descending anterior coronary artery
Possible relations with the problem of collateral circulation
Left coronary arteries of 30 human
hearts, obtained at autopsy, were injected with
contrast medium. A control group was formed
from anterior descending coronary arteries free of
atherosclerosis and a study group from anterior
descending coronary arteries with areas of atherosclerotic
injury. The following differences in the
two groups were noted. The control group did not
show successfully injected vessels in intima and media,
while cases with atherosclerotic injury have
them; the number of injected vessels in presence
of atherosclerotic injury was three times greater
than in healthy coronary arteries; there was a decreasing
gradient from outside to in, in the number
of injected vessels in both groups; and finally in
atherosclerotic vessels we noted a lack of balance
between parietal thickening and the residual lumen
(conspicuous thickening was accompanied by a
small reduction in the lumen). We interpret centrifugal
thickening as a possible compensatory mechanism
in the major branches for an inadequate canalization
of vessel, and suggest possible formation
of coronary collateral circulation from vasa vasorum
by a process of neovascularization.
