Hemodynamics of Vascular Disease: Applications to Diagnosis and Treatment

Healing of Diabetic Neuroischemic Foot Wounds With vs Without Wound-Targeted Revascularization: Preliminary Observations From an 8-Year Prospective Dual-Center Registry

“…This observation may also explain why a few large collaterals appear more efficient in CLTI flow redistribution than hundreds of small collaterals and other interangiosomal choke vessels during similar ischemic threats. 8,44,45 The present study sustains this hypothesis by reporting significant variations between WTR/IR and WTRc/IR groups in terms of healing and limb preservation.…”

“…7,44 It becomes evident that not all collaterals are able to share the same capacity, flow, and hemodynamic function during CLTI progression, 34,42,43 particularly in diabetic patients. 17,33,34,38 From a straight hemodynamic perspective, Summers et al 45 documented in normal subjects that about "16 collaterals with a 0.25-cm diameter may equal 625 collaterals with 0.1-cm diameter" and compensate for "an unobstructed artery of 0.5 cm diameter." This observation may also explain why a few large collaterals appear more efficient in CLTI flow redistribution than hundreds of small collaterals and other interangiosomal choke vessels during similar ischemic threats.…”

“…Aiming to standardize different individual collateral patterns, a few classification systems have been proposed in the contemporary literature. 4,8,42,45 One of these is a 6-level digressive inferior limb arterial ramification scale, including the angiosomal, the appended collateral, and the choke vessels arrangements. 8,34 As for direct vs indirect revascularization definitions, this research also highlights the need for uniform "collateral" and "source artery" reporting standards, 8,46 particularly for current CLTI revascularization.…”

Effective hemodynamic diameter: An intrinsic property of vein grafts with predictive value for patency

“…More recently, Idu et al 23 concluded that the only factor significantly affecting the development of vein graft stenoses was a minimum graft diameter less than 3.5 mm. These data are strengthened by theoretical considerations put forth by David Sumner 24 who noted that, according to Poiseuille's law, long segments of a graft with diameters less than 3.0 mm generate unacceptably high pressure gradients.…”

Grades of Below-the-Ankle Arterial Occlusive Disease following the Angiosome Perfusion: A New Morphological Assessment and Correlations with the Inframalleolar GVG Stratification in CLTI Patients

“…The clinical value of all these studies that support or refute specific postoperative angiosomal microcirculatory changes is indisputable. However, several recognized physiological phases for tissue reperfusion 10,16,46,47 such as the gradual opening of the wider physiological angiosome 17 containing its "active" or "dormant" collaterals 10,16,17,30,38 , and the existence of the postoperative delay-phenomenon in tissue flow redistribution 17,48,49 , all add novel and valuable information about delayed increment and the opening of compensatory inter-angiosomal collaterals 4,9,49,50 . This observation needs to be considered in parallel with the arteriogenesis and the angiogenesis processes 10,16,47,51 .…”