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Results for “Collateral Circulation”

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At least 649 records · Page 36Linked to original sources
PubMed1989

Collateral circulation to the diagonal artery from the infundibular coronary artery in obstructive coronary arterial disease.

We report an unusual collateral pathway from the isolated infundibular (third coronary) artery to the diagonal artery in a young adult male with a history of recent anteroseptal myocardial infarction and apparently angiographically normal left and right coronary arteries. The isolated infundibular (conus) artery is an important source of collateral pathways in obstructive coronary arterial disease. Its selective arteriography is essential for complete angiographic evaluation of these patients.

Adult↗
PubMed1983

Beneficial effects of the coronary collateral circulation on tachycardia-induced myocardial ischemia during experimental coronary stenosis.

This study was designed to determine whether coronary collaterals have preventive effects on tachycardia-induced myocardial ischemia under partial restriction of proximal coronary artery inflow. Studies were carried out in dogs with developed coronary collaterals and control dogs. ST-elevation in epicardial and intramyocardial electrograms was used for assessing the degree of regional myocardial ischemia. In control dogs with coronary constriction (80% reduction of i.d.) pacing-induced tachycardia produced significant ST-elevation, 1.48 +/- 0.17 mV in the inner layer and 0.79 +/- 0.29 mV in the middle layer at a cardiac rate of 150/min, 3.58 +/- 0.38 mV in the inner layer, 2.73 +/- 0.38 mV in the middle layer, and 1.93 +/- 0.36 mV in the outer layer at a rate of 180/min. In dogs with moderate collaterals ST-segment elevation was only 1.41 +/- 0.18 mV in the inner layer and 0.96 +/- 0.24 mV in the middle layer at a rate of 180/min. In dogs with abundant collaterals there was no significant ST-elevation during tachycardia. These findings indicate that blood supply to the affected myocardium via developed collaterals is sufficient to meet graded increases in metabolic requirements under the condition of limited coronary flow reserve in an experimental model simulating angina pectoris.

Animals↗
PubMed1998

Collateral circulation and outcome after basilar artery thrombolysis.

BACKGROUND AND PURPOSE: This study was undertaken to examine the relationship between collateral flow and outcome after local intraarterial thrombolytic treatment for basilar artery thrombosis. METHODS: Twenty-four patients with symptomatic basilar thrombosis were treated with intraarterial urokinase. Angiograms at the time of treatment were analyzed to characterize collateral flow. The number of posterior communicating arteries (PCoAs) and the degree of collateral filling of the basilar artery were then compared with symptom duration before treatment, with Glasgow Coma Scale (GCS) score at the time of treatment, with 90-day modified Rankin score, and with 90-day survival status. RESULTS: Of the 20 patients who had carotid artery injections at the time of the thrombolytic procedure, two had no PCoA, eight had one PCoA, and 10 had two PCoAs. Nine had no collateral opacification of the basilar artery, six had collateral opacification of the distal basilar artery, and five had collateral opacification of the distal and proximal basilar artery. Ninety-day survival was 38%; 25% of patients had good neurologic outcomes. No correlation was found between the number of PCoAs and symptom duration, pretreatment GCS score, survival, or neurologic outcome. Duration of symptoms before treatment was longer in patients with collateral flow to the basilar artery. Basilar artery collateral flow did not correlate with survival, but it did correlate with neurologic outcome for the 12 patients with middle or distal basilar artery thrombus in whom collateral flow to the basilar artery was assessed (83% with collateral flow had good neurologic outcomes, but only 17% without collateral flow had good outcomes). All six patients with proximal basilar artery thrombus in whom collateral flow was assessed died, independent of the collateral flow observed. CONCLUSION: In symptomatic acute basilar artery thrombosis, neurologic outcome was better after intraarterial thrombolysis in patients who had collateral filling of the basilar artery, except in cases of proximal basilar thrombosis. Patients with collateral filling of the basilar artery also tolerated longer symptom duration.

Basilar Artery↗
PubMed1978

Pharmacological alterations of coronary collateral circulation; implication to the steal-phenomenon.

Measurements of resistances were performed on different parts of coronary vessels, including spontaneous collaterals in anesthetized dogs, following ligation and embolization of the descending branch of the left coronary artery. The normal situation was compared with the state of maximal pharmacological dilatation. The pharmacological dilatation decreased the collateral resistance by 24% in spite of the fact that the collaterals supplied an infarcted area in this case; the precollateral resistance, which chiefly consists of large vessels was also diminished. The collateral perfusion pressure is not only dependent on the aortic pressure, but also on the flow rate in the corresponding large coronary vessel and thereby on the ratio of precollateral to postcollateal resistance. A decrease of the collateral perfusion pressure causes an insufficient perfusion of the area supplied by the collaterals only when the pressure fall is not compensated for by an adequate decrease in the collateral resistance and when the ratio of the collateral to the nutritive resistance increases. Thus, both, the extent of the pressure fall across the precollateral resistance and the dilating capacity of the collaterals determine whether is not a pharmacological dilatation of the coronary vascular bed results in an insufficient supply of an infarcted area, i.e. in a so called "Steal-phenomenon". The results show further, that the given physical model of the microcirculation satisfactorily approximates the observed behaviour of the vascular system.

Animals↗