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Results for “Collateral Circulation”

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At least 811 records · Page 45Linked to original sources

PubMed1988

Improvement of treadmill capacity and collateral circulation as a result of exercise with heparin pretreatment in patients with effort angina.

It has been demonstrated in animal experiments that heparin accelerates the coronary collateral development induced by repeated coronary occlusion. We used this effect of heparin for the treatment of patients with stable effort angina. In 10 patients, treadmill exercise was performed according to standard Bruce protocol twice a day for 10 days. A single intravenous dose of heparin (5000 IU) was given 10 to 20 min before each exercise period. Exercise with heparin pretreatment increased the total exercise duration from 6.3 +/- 1.9 (SD) to 9.1 +/- 2.2 min (p less than .001) and the maximal double product (DP) from 18,900 +/- 5100 to 25,500 +/- 6800 mm Hg.beats/min (p less than .001). The DP at the onset of angina was also increased by 35% (p less than .01) and the DP at which ST depression (0.1 mV) first appeared was 19% (p less than .05) greater after treatment. Repeat coronary cineangiography revealed an increase in the extent of opacification of collaterals to the jeopardized myocardium. In an additional six patients, treadmill exercise was performed with no medication twice a day for 10 days. All of the above-mentioned variables of treadmill capacity remained unchanged, despite 20 exercise periods without heparin pretreatment. Thus, heparin accelerates exercise-induced coronary collateral development by promoting angiogenesis. The development of such a therapeutic modality will open a new field for the treatment of patients with ischemia.

Angina Pectoris↗

PubMed2000

Angiographically defined collateral circulation and risk of stroke in patients with severe carotid artery stenosis. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group.

BACKGROUND AND PURPOSE: Blood supply through collateral pathways improves regional cerebral blood flow and may protect against ischemic events. The effect of collaterals on the risk of stroke and transient ischemic attack (TIA), in the presence of angiographic severe internal carotid artery (ICA) stenosis, was assessed. METHODS: Angiographic collateral filling through anterior communicating and posterior communicating arteries and retrograde filling through ophthalmic arteries were determined in all patients at entry into the North American Symptomatic Carotid Endarterectomy Trial. Kaplan-Meier event-free survival analyses were performed on 339 medically treated and 342 surgically treated patients. RESULTS: The presence of collaterals supplying the symptomatic ICA increased with severity of stenosis. Two-year risk of hemispheric stroke in medically treated patients with severe ICA stenosis was reduced in the presence of collaterals: 27.8% to 11.3% (P=0.005). Similar reductions were observed for hemispheric TIA (36.1% versus 19.1%; P=0.008) and disabling or fatal strokes (13.3% versus 6.3%; P=0.11). For surgically treated patients, the perioperative risk of hemispheric stroke was 1.1% in the presence of collaterals versus 4. 9% when absent. The 2-year stroke risks for surgical patients with and without collaterals were 5.9% versus 8.4%, respectively. Neither comparison in the surgical group was statistically significant. The observed reductions were independent of the degree of ICA stenosis and other vascular risk factors. CONCLUSIONS: Collaterals are associated with a lower risk of hemispheric stroke and TIA, both long term and perioperatively. Angiographic identification of collaterals assists in identifying patients with severe ICA stenosis at lower risk of stroke and TIA.

Aged↗

PubMed1982

Collateral circulation secondary to upper extremity venous thrombosis visualized during excretory urography.

Unsuspected upper extremity venous thrombosis was observed in three patients undergoing excretory urography. Thoraco-abdominal collateral vessels were readily visible following an intravenous bolus injection of contrast material into a vein in the affected extremity. The increased incidence of upper extremity venous thrombosis is probably due to the frequent use of subclavian vein catheterization for parenteral nutrition, central venous monitoring, and cardiac pacing. The collateral pathways are characteristic and can easily be recognized.

Adolescent↗

PubMed1990

[Characteristics of collateral circulation in the ophthalmic artery before and after cerebral revascularization in patients with multiple occlusive diseases of the major arteries of the head].

The status of the collateral blood flow was examined before and after establishment of ++extra-intracranial microarterial anastomosis (EICMA) in 70 patients with occlusion of the internal carotid artery. Of these, 93% of the patients also had lesions of the other main arteries of the head. It has been established that in concomitant lesions of the main arteries of the brain, the role of the ophthalmic artery (OA) rises as to the compensation for the blood flow in the damaged hemisphere. Involvement of the ophthalmic anastomosis into blood supply of the damaged hemisphere was found to inversely correlated to EICMA function. Active functioning of EICMA brings about a decrease of the retrograde blood flow in the OA and in some cases, alteration in the direction of the blood flow in that artery, namely from retrograde to antegrade. Nevertheless additional blood flow via EICMA promotes elevation of the level of the cerebral blood flow in the regions of the middle cerebral artery basin, supplied via the microarterial anastomosis.

Adult↗

PubMed1957