Influence Of Collateral Circulation Research Articles

The Correlation of Collateral Circulation and Age during Acute Ischemic Heart Disease

Backgroundː Coronary collaterals (CC) are alternative sources of blood supply to myocardium jeopardized by Ischemia. Aim: To investigate the dependence and influence of collateral circulation on age during acute ischemic heart disease. Methods: Analysis shows that 673 patients were studied from the SamgoriMedi Clinic (Tbilisi, Georgia) aged 27– 94 years (64.7+11.48) with acute coronary syndromes. Basic medical data such as sex, age, cardiovascular risk factors, angina pectoris, revascularization history, echocardiography, and laboratory data were obtained from the patient’s medical records. CC vessels were graded according to the Rentrop grading system of 0 to 3. Resultsː The development index of collateral circulations visibly increases with age. Average age increases accordingly as follows: rentrop 0 - 62.85+12.01, rentrop 1 - 64.90+10.79, rentrop 2 - 66.84+10.49, and rentrop 3 - 69.04+9.68 (p<0.0001). There is positive significant correlation between the development of collateral circulation and age groups r=0.170**, p<0.001. The cases of female sex, hypertension, acute MI without ST elevation, CABG frequency (also EF% - 35-45%, <35%), and multiple vessel coronary lesion are noticed to increase with age, while the male sex and EF (ejection fraction) >45% cases decreases with age. Conclusion Collateral circulation shows significantly positive correlation with age and female sex. However, it should be mentioned that in elderly patients with a high ejection fraction and normal diastolic function, the development of collateral vessels is low.

Influence of collateral circulation on cerebral blood flow and frontal lobe cognitive function in patients with severe internal carotid artery stenosis

BackgroundThis study aimed to investigate the cerebral blood flow (CBF) and frontal lobe cognitive function in severe internal carotid artery (ICA) stenosis patients with different types of collateral circulation.MethodsOne hundred twenty-six patients with severe unilateral ICA stenosis were enrolled. Digital subtraction angiography (DSA) was performed to recruit patients with one of three common types of collateral circulation: anterior communicating artery (AcoA), posterior communicating artery (PcoA) and ophthalmic artery (OA). The hemodynamic parameters of the middle cerebral artery (MCA) were measured using transcranial Doppler (TCD), and the individual frontal lobe cognitive attention functions were evaluated using Word Fluency Test, Trail-Making Test (TMT), Digit Span, and Stroop Color Word Test (SCWT). The correlation between hemodynamic changes and the scores of all tasks was analyzed.ResultsOn the side of arterial stenosis, the CBF velocities were highest in AcoA group and lowest in the OA group. All patients performed worse in TMT and Digit Span than the matched normal controls. The AcoA group exhibited a lower pulsatility index (PI) and a longer response time in the Stroop task, but had a higher accuracy rate in the Stroop task and higher scores in Word Fluency Test than the PcoA and OA groups. In all the three groups, PI was positively correlated with the accuracy rate for Stroop interference effects.ConclusionsOur findings suggested that the frontal lobe cognitive function of patients with ICA was impaired, and AcoA collaterals may be beneficial for selective attention functions, whereas OA collaterals may be associated with impairment of selective attention functions. Additionally, a high PI may be an indicator for identifying impaired selective attention in patients with severe ICA stenosis.

Effects of collateral circulation on prognosis of acute ischemic stroke

Acute ischemic stroke is one of the main causes of long-term morbidity and mortality in developed and developing countries. Collateral circulation, as a compensatory method after ischemia, is affected by many factors and plays an important role in the prevention and treatment of acute ischemic stroke. The influence of collateral circulation on the clinical prognosis and treatment choice of patients with acute ischemic stroke has become a hot topic. Good collateral state can not only reduce the severity of early stroke, but also improve functional recovery after 3 months after stroke. This article reviews the effects of collateral circulation on the prognosis of acute ischemic stroke. Key words: Collateral circulation; Ischemic attack, transient; Stroke; Review

The influence of collateral circulation recruitment on various cognitive functions after severe unilateral stenosis or unilateral occlusion of the internal carotid artery

Objective To investigate the influence of collateral circulation recruitment on cognitive functions in patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery by using TCD. Methods A total of 176 patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery were enrolled and were divided into a single vessel collateral group(n=80, 45.5%), a multiple vessel collateral group(n=74, 42.1%)and a no collateral group(n=22, 12.5%). In order to study the influence of single vessel collateral circulation on cognitive functions, the single vessel collateral group was further divided into an anterior communicating subgroup(AcoA), a posterior communicating subgroup(PcoA), an ocular artery subgroup(OA), and a normal control subgroup.All patients and 34 normal controls(NC)received MoCA, and scores for the overall assessment and individual domains were analyzed. Results Compared with the control group(26.3±1.1, 4.7±0.5, 2.0±0.0, 3.6±1.0), the multiple vessel collateral group, the single vessel collateral group and the no collateral group had lower overall scores(24.2±1.7, 21.9±2.3, 19.0±2.4), lower executive/visuospatial function(3.9±0.7, 3.2±0.8, 2.4±0.6), lower abstraction(1.7±0.5, 1.6±0.5, 1.3±0.5), and lower delayed recall(2.9±0.8, 1.9±0.8, 1.6±0.5)(F=80.52, 63.21, 12, 48.99, all P<0.05); both collateral groups had lower scores in subtraction and attention(4.6±0.6 vs. 5.2±0.7, 4.3±0.7 vs. 5.2±0.7); the no collateral group had lower scores in orientation(4.7±0.7 vs. 5.7±0.5)(P<0.05). Compared with the multiple vessel collateral group, both the single vessel collateral group and the no collateral group had lower overall scores(21.9±2.3 vs. 24.2±1.7, 19.0±2.4 vs. 24.2±1.7), executive/visuospatial function(3.2±0.8 vs. 3.9±0.7, 2.4±0.6 vs. 3.9±0.7), subtraction and attention(4.6±0.6 vs. 5.1±0.5, 4.3±0.7 vs. 5.1±0.5)(all P<0.05); the no collateral group had lower scores in abstraction(1.3±0.5 vs. 1.7±0.5), delayed recall(1.6±0.5 vs. 2.9±0.8)and orientation(4.7±0.7 vs. 5.7±0.5)(all P<0.05). Compared with the single vessel collateral group, the no collateral group had lower overall scores(19.0±2.4 vs. 21.9±2.3), executive/visuospatial function(2.4±0.6 vs. 3.2±0.8)and orientation(4.7±0.7 vs. 5.7±0.6)(all P<0.05). In single vessel collateral patients, the AcoA subgroup had higher MoCA scores than the PcoA subgroup(22.9±1.7 vs. 21.2±2.7)(P<0.05), and the AcoA subgroup had higher scores in delayed recall than the OA subgroup(2.2±0.8 vs. 1.7±0.6)(P<0.05). Conclusions Severe unilateral stenosis or unilateral occlusion in the internal carotid artery can result in cognitive impairment, especially in executive/visuospatial function, abstraction, delayed recall, subtraction and attention.However, collateral circulation can protect cognitive function in patients with unilateral internal carotid artery stenosis or occlusion and multiple vessel collateral circulation is more effective than single vessel collateral circulation, and AcoA is more effective than either PcoA or OA, but the difference between PcoA and OA is not significant. Key words: Transcranial Doppler; Internal carotid artery; Severe stenosis or occlusion; Collateral circulation; Cognitive function

24 The physiological impact of coronary chronic total occlusion (cto) percutaneous coronary intervention (pci) on donor vessel coronary pressure-derived measurements and the influence of collateral circulation

BackgroundThere is strong evidence of FFR guided treatment in multi-vessel disease. Multi-vessel disease is present in up to 66% of patients with CTO in a large registry analysis. The presence...

Progressive changes in cerebral perfusion after carotid stenting: a dynamic susceptibility contrast perfusion weighted imaging study

BackgroundWe aimed to assess baseline inter-hemispheric perfusion differences, before carotid artery stenting (CAS), of severe internal carotid artery (ICA) stenosis, and to evaluate perfusion changes over time after CAS by...

The influence of collateral circulation on the detection of coronary artery stenosis by dipyridamole MIBI scintigraphy

Dipyridamole is often used as an alternative to exercise in the detection of coronary artery disease by radionuclide techniques. For analyzing the dipyridamole-induced chest pain encountered during this test we studied a group of 47 patients who underwent MIBI SPECT imaging at rest and after the injection of up to 0.84 mg/kg dipyridamole. Coronary arteriography was available in a subgroup of 21 patients. A significant relation was found between chest pain during dipyridamole injection and ischemic electrocardiogram changes in the study group. In the subgroup of 21 patients with coronary angiography, an association was found between chest pain and the presence of collateral circulation. The MIBI perfusion defects were also more prevalent in the group with collaterals. These findings can be explained by the induction of coronary steal after dipyridamole in the group with a collateral circulation. This coronary steal causes real ischemia in the collateralized region. We conclude that in patients with known coronary artery disease, dipyridamole MIBI imaging allows for the selection of those patients with significant coronary stenosis with a collateral circulation. In this way, dipyridamole selects a group of patients who may be at lower risk in case of acute occlusion of the artery.

Cut-Off Value of Coronary Flow Velocity Reserve by Transthoracic Doppler Echocardiography for the Assessment of Significant Donor Left Anterior Descending Artery Stenosis in Patients With Spontaneously Visible Collaterals

We evaluated the influence of collateral circulation on a donor left anterior descending artery and an appropriate cut-off value of coronary flow velocity reserve for the diagnosis of significant donor left anterior descending artery stenosis. Measurement of coronary flow velocity reserve by transthoracic Doppler echocardiography provides noninvasive assessment of significant left anterior descending artery stenosis. The cut-off value of coronary flow velocity reserve for the diagnosis of significant donor left anterior descending artery stenosis has not been well studied. We retrospectively examined 64 patients who had no significant left anterior descending artery stenosis and who had other coronary artery stenosis. Seventeen patients had collaterals from the left anterior descending artery (group A) and 47 patients did not have collaterals (group B). We prospectively examined 23 consecutive patients who had collaterals from the left anterior descending artery to other coronary arteries. Eight patients had a significant donor left anterior descending artery stenosis. Coronary flow velocity reserve assessment was performed by transthoracic Doppler echocardiography in the 2 protocols. Coronary flow velocity at baseline in group A was significantly higher than that in group B. Coronary flow velocity reserve in group A was significantly lower than that in group B (2.6 +/- 0.8 vs 3.2 +/- 0.9, p < 0.05). Coronary flow velocity during hyperemia and coronary flow velocity reserve were significantly lower in patients with significant stenosis. A cut-off value of 2.0 of coronary flow velocity reserve had a sensitivity of 88% and a specificity of 93% for the diagnosis of significant donor left anterior descending artery stenosis. In conclusion, coronary flow velocity reserve of a donor left anterior descending artery was decreased by the presence of collaterals. However, a cut-off value < 2.0 was appropriate for the diagnosis of significant donor left anterior descending artery stenosis in a population that included patients with collaterals.

The influence of collateral circulation on the graft flow in the patients with aortocoronary bypass grafting

The influence of collateral circulation on the graft flow in the patients with aortocoronary bypass grafting

The influence of collateral circulation on the detection of coronary artery stenosis by dipyridamole MIBI scintigraphy

Dipyridamole is often used as an alternative to exercise in the detection of coronary artery disease by radionuclide techniques. For analyzing the dipyridamole-induced chest pain encountered during this test we studied a group of 47 patients who underwent MIBI SPECT imaging at rest and after the injection of up to 0.84 mg/kg dipyridamole. Coronary arteriography was available in a subgroup of 21 patients. A significant relation was found between chest pain during dipyridamole injection and ischemic electrocardiogram changes in the study group. In the subgroup of 21 patients with coronary angiography, an association was found between chest pain and the presence of collateral circulation. The MIBI perfusion defects were also more prevalent in the group with collaterals. These findings can be explained by the induction of coronary steal after dipyridamole in the group with a collateral circulation. This coronary steal causes real ischemia in the collateralized region. We conclude that in patients with known coronary artery disease, dipyridamole MIBI imaging allows for the selection of those patients with significant coronary stenosis with a collateral circulation. In this way, dipyridamole selects a group of patients who may be at lower risk in case of acute occlusion of the artery.

心電図同期血流流速波形解析装置の開発とＡ‐Ｃバイパス術後グラフト流量解析への応用 側副血行路の影響について

心電図同期血流流速波形解析装置の開発とＡ‐Ｃバイパス術後グラフト流量解析への応用 側副血行路の影響について

The influence of collateral circulation on amputation

Collateral circulation in the left limb was developed in adult rabbits by ligation of the femoral artery, after which below knee amputation was performed at various time intervals. The muscle blood flow (MBF) was assessed by 133 Xenon and Histamine. The investigation showed that the length of time between the two operations strongly influenced the function of the collaterals. Simultaneous ligation of the artery and amputation resulted in a prolonged reduction in MBF, whereas amputation 3 days after ligation of the artery resulted in an immediate increase in blood flow in the amputation stump. A 10-week interval between arterial occlusion and amputation gave an initial reduction in blood flow.