Atherosclerotic Disease of the Coronary Arteries

Abstract

Coronary arteries (479 segments of 50 human hearts were studied to determine whether postmortem arteriograms provided accurate information on coronary stenosis and occlusion. Whether arterial stenoses or occlusions were nonfocal or focal (obstruction less than 5mm. long), and the degree of luminal obstruction present, were determined. In nonfocal disease; luminal obstruction was graded exactly the same by arteriography as by gross anatomic examination in 61% of 479 segments, was underestimated by arteriography in 22%, and was overestimated in 17%. Coexisting focal involvement was graded the same by the two methods in 11% of 89 segments, was underestimated by arteriography in 86%, and was overestimated in only 3%. Accuracy of arteriographic estimation of severe obstruction was very poor in nonfocal disease, but not affected in focal disease. In segments of arteries most accessible to direct operation, arteriographic estimation of obstruction was least reliable.