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Determination of the angiographic appearance of coronary collateral vessels the importance of supplying and recipient arteries

Determination of the angiographic appearance of coronary collateral vessels the importance of supplying and recipient arteries

American Journal of Cardiology 51(3): 434-439

The appearance of coronary collateral vessels at coronary angiography generally is believed to provide additional information regarding coronary flow and myocardial O2 supply beyond that obtained from angiographic assessment of the large coronary arteries. To evaluate the adequacy of this assumption, to determine the relation between the angiographic appearance of coronary arteries and of coronary collateral vessels, and to gain additional insight into the mechanisms governing collateral flow in man, the coronary arteriograms of 121 patients in whom at least 1 coronary artery manifested .gtoreq. 75% stenosis (193 arteries demonstrated .gtoreq. 90% stenosis, and 94 of these were totally occluded) were examined. Collateral vessels were graded absent, poor or good based on the size and intensity of filling. Stenosis of the recipient artery significantly affected the angiographic appearance of collateral vessels. No artery with < 90% stenosis received angiographically detectable collateral vessels; 118 of the 193 vessels with .gtoreq. 90% stenosis received collateral vessels: 79 of 94 (84%) totally occluded arteries vs. 39 of 99 (39%) with .gtoreq. 90% but < 100% stenosis (P < 0.001). Good collateral vessels went to 70 of the 79 (89%) totally occluded arteries, but only 17 of 39 (49%) subtotally occluded arteries (P < 0.001). Of the 87 good collateral vessels, only 16 (18%) were supplied by single arteries manifesting .gtoreq. 75% stenosis; of 31 poor collateral vessels, 20 (65%) were supplied by arteries with .gtoreq. 75% stenosis (P < 0.001). When the patency of all the arteries that could supply collateral vessels to the 94 totally occluded was semiquantitated, the extent of obstruction of the potential suppliers was significantly greater in those arteries with none or poor collateral vessels (P < 0.001 for both groups of arteries with good collateral vessels). The angiographic appearance of the recipient and supplying coronary arteries is a major predictive factor in the angiographic appearance of coronary collateral vessels.

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Accession: 005127174

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PMID: 6823857

DOI: 10.1016/s0002-9149(83)80075-7

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