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At least 739 records · Page 41Linked to original sources
PubMed1985

Cilioretinal collateral circulation after occlusion of the central retinal artery.

Two elderly patients were noted to have unilateral central retinal arterial narrowing with cilioretinal arterial collaterals supplying the bulk of the flow to the inner retina. One patient had excellent acuity and normal pupillary reactions; the other had marked impairment of vision and an afferent pupillary defect. Both patients were asymptomatic. We suggest that these patients had gradual or partial central retinal arterial occlusion which allowed the development of a collateral arterial supply from the ciliary system.

Aged↗
PubMed1994

Spinal cord protection in the absence of collateral circulation: meta-analysis of mortality and paraplegia.

A meta-analysis of paraplegia complicating aortic surgery on patients having neither intercostal nor spinal collaterals, epitomized by patients with acute traumatic aortic rupture, was done. Index Medicus and Medline were searched for all suitable English publications between 1972 and 1992. New paraplegia occurred in 9.9% of 1492 patients who underwent surgery. However, 19.2% of patients undergoing surgery with only simple aortic cross-clamping developed paraplegia, in contrast to 6.1% if distal aortic perfusion was augmented by either "passive" or "active" methods (p < 0.00001). The risk of paraplegia increased progressively as cross-clamp times lengthened if simple aortic cross-clamping was used (p < 0.00001), but only once did the cross-clamp time exceed 30 minutes (p < 0.05). Paraplegia occurred in 8.2% of patients with "passive" shunts from the ascending aorta (p < 0.001 vs simple cross-clamping). Shunts from the left ventricular apex, however, had an incidence of paraplegia of 26.1% and, therefore, did not decrease the risk of paraplegia. "Active" augmentation of distal perfusion had the lowest risk of paraplegia: 2.3% (p < 0.00001 vs simple cross-clamping or "passive" shunts). Mortality, however, was higher in these potentially polytraumatized patients when they were perfused distally using methods requiring full systemic heparinization (18.2%), compared to mortality with methods not requiring heparin (11.9%; p < 0.01). In conclusion, simple aortic cross-clamping has a high risk of paraplegia if the cross-clamp time extends beyond 30 minutes. "Active" modalities of augmenting distal perfusion provide optimal spinal protection.

Aorta, Thoracic↗
PubMed1983

Intravenous digital subtraction angiography. Collateral circulation to 'empty leg'.

Among 60 patients with uni- or bilateral occlusion of the common or external iliac arteries or both, 12 patients had collateral blood supply originating from the internal mammary or lateral thoracic arteries, or both. By means of intravenous digital subtraction angiography the thoracic arterial pathways and the non-occluded arteries of both legs, simultaneously, were easily demonstrated using the 30 cm effective field size of a Sirecon 33 triplex N image intensifier.

Adult↗