Fate of collateral circulation after successful coronary angioplasty of total occlusion assessed by coronary angiography and myocardial contrast echocardiography

Ha, Jong Won; Cho, Seung Yun; Chung, Namsik; Choi, Donghoon; Choi, Byung Joo; Jang, Yangsoo; Shim, Won Heum; Kim, Sung Soon

doi:10.1067/mje.2002.115185

Cited by 9 publications

(6 citation statements)

References 40 publications

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“…MCE however showed that 35% of the patients still had a demonstrable collateral flow. 93 Cost and image quality are major limitations to the routine use of MCE.…”

Section: Non-invasive Methods For Quantifying the Collateral Circulationmentioning

confidence: 99%

Collateralization and the response to obstruction of epicardial coronary arteries

Tayebjee

Lip

MacFadyen

2004

QJM: An International Journal of Medicine

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Occlusive coronary disease is an important cause of global morbidity and mortality. While mechanical revascularization is effective, some individuals are not amenable to such interventions, and have a poorer prognosis. However, collateral circulation can protect and preserve myocardium around the time of coronary occlusion, contribute to better residual myocardial contractility, and lessen symptoms. We describe the anatomy and physiology of coronary collateralization, its component parts (angiogenesis and arteriogenesis), the current methods for definition of the collateral response and how this might be manipulated. The manipulation of this process is a realistic possibility for future adjuvant treatment of coronary artery disease.

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“…MCE however showed that 35% of the patients still had a demonstrable collateral flow. 93 Cost and image quality are major limitations to the routine use of MCE.…”

Section: Non-invasive Methods For Quantifying the Collateral Circulationmentioning

confidence: 99%

Collateralization and the response to obstruction of epicardial coronary arteries

Tayebjee

Lip

MacFadyen

2004

QJM: An International Journal of Medicine

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“…The compromise of collaterals after percutaneous intervention is well documented in the coronary literature. 29–33 This is thought to be a consequence of direct mechanical obstruction of collateral flow and collateral regression following treatment of the hemodynamically significant lesion with subsequent decreased shear stress. 29–33 Compromised collateral flow may be one potential explanation of why when secondary bypasses fail, the risk of limb-threatening ischemia and subsequent amputation is higher than when primary bypasses fail.…”

Section: Compromised Collateral Flowmentioning

confidence: 99%

“…29–33 This is thought to be a consequence of direct mechanical obstruction of collateral flow and collateral regression following treatment of the hemodynamically significant lesion with subsequent decreased shear stress. 29–33 Compromised collateral flow may be one potential explanation of why when secondary bypasses fail, the risk of limb-threatening ischemia and subsequent amputation is higher than when primary bypasses fail. 6,8,9 CLI patients have well developed collateral networks that bestow a degree of tolerance and physiologic reserve to acute graft occlusions.…”

Section: Compromised Collateral Flowmentioning

confidence: 99%

Burning Bridges

2015

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“…The product A from the replenishment curve is considered to indicate MCE-derived MBF, as many studies have reported that MCE-derived MBF correlates well with radiolabeled microsphere-derived MBF [4,[14][15][16][17]. However, Coggins et al mentioned that the flow speed through the micro-collateral vessels can be extremely slow [14].…”

Section: Video Intensity 30 Sec After Burst Vs Replenishment Curvementioning

confidence: 99%

“…Myocardial perfusion through the collateral circulation can also be observed using MCE [7][8][9][10][11][12][13][14][15][16][17], and real-time MCE may be effective for analyzing collateral perfusion at various levels of blood pressure.…”

mentioning

confidence: 99%

Nicorandil Preserves Coronary Collateral Circulation Compared to Nitroglycerin Even in Systemic Hypotension: A Real-Time Myocardial Contrast Echocardiographic Study

et al. 2004

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Background. Although collateral circulation is important for myocardial salvage in acute coronary syndrome, effects of collaterals are significantly reduced by systemic hypotension. The objective of this study is to evaluate the effects of nitroglycerin and nicorandil on micro-collateral circulation during systemic hypotension.Methods. Real-time myocardial contrast echocardiography (MCE) was performed in 15 open-chest dogs during occlusion of the left circumflex artery using a snare. Ischemic area was identified using high ultrasound power exposure (burst) just after coronary occlusion. Micro-collateral vessels were recognized by re-opacification during 30 seconds of occlusion. Final subjects for this study were 8 of the 15 dogs that displayed micro-collateral vessels. Flow volume of the donor artery, i.e., the left anterior descending coronary artery (LAD), was measured. Video intensity (VI) were measured and percent wall thickening (%WT) was calculated. Replenishment curves of VI for the ischemic area after burst were obtained and used in the exponential function y=A (1-e t ), for estimation of myocardial blood flow volume (A ). These indices were compared at control and during hypotension after nitroglycerin (0.01-0.02 mg/kg) or nicorandil (0.1-0.2 mg/kg) administration.Results. Equivalent hypotension was induced by each drug. VI, %WT and A at the ischemic area were significantly decreased after nitroglycerin (p<0.05) administration, but not after nicorandil. Nicorandil increased LAD flow from 6.1 2.3 ml/min to 8.8 2.1 ml/min, but nitroglycerin did not. Conclusion.Compared with nitroglycerin, nicorandil offers better preservation of coronary collateral circulation, even during systemic hypotension. (J Echocardiogr 2004; 2: 90-98)

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Fate of collateral circulation after successful coronary angioplasty of total occlusion assessed by coronary angiography and myocardial contrast echocardiography

Cited by 9 publications

References 40 publications

Collateralization and the response to obstruction of epicardial coronary arteries

Collateralization and the response to obstruction of epicardial coronary arteries

Burning Bridges

Nicorandil Preserves Coronary Collateral Circulation Compared to Nitroglycerin Even in Systemic Hypotension: A Real-Time Myocardial Contrast Echocardiographic Study

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