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PubMed1975

[The collateral circulation for occlusion of the three unpaired abdominal arteries (author's transl)].

A fifty-two year old patient had only a short period of abdominal angina, despite occlusion of all three unpaired abdominal aortic branches. An extensive collateral system provided the circulation to the abdominal organs: intercostal arteries and adrenal vessels through the inferior phrenic artery for the coeliac trunk; arteries from the left iliac for the inferior mesenteric artery and through Riolan's arc (type II) for the superior mesenteric artery. Lumbar vessels provided a supply to the proximal territory of the superior mesenteric artery. In addition, it was possible to demonstrate connections between several lumbar arteries; several of these were also occluded proximally.

Abdomen↗
PubMed1989

[Veloergometric indicators in patients with ischemic heart disease depending on collateral circulation].

The dynamics was studied of tolerance to physical load in the course of three-year prophylactic medical care of 60 male with ischemic heart disease (functional class II-III) against the background of antianginal therapy related to presence or absence of collateral blood flow as evidenced by coronaroangiography. The presence of collateral blood flow in patients with ischemic heart disease is considered as a sign of marked hemodynamic disorder in the system of the stenosed blood vessel leading to myocardial ischemia, reduction of the contractile function and a more severe clinical course of ischemic heart disease with a possible development of reinfarctions of the myocardium and advancing reduction of tolerance to physical load.

Collateral Circulation↗
PubMed2003

MR findings of collateral circulation are more accurate measures of hemodynamic significance than arm-leg blood pressure gradient after repair of coarctation of the aorta.

PURPOSE: To determine the relationship between percent stenosis and three indicators of hemodynamic significance-arm-leg blood pressure gradient, direct visualization of collaterals, and percent increase flow from proximal to distal descending thoracic aorta-in patients with prior repair of coarctation of the aorta (CoA). MATERIALS AND METHODS: Magnetic resonance imaging (MRI) examinations of 19 patients with prior repair of CoA were retrospectively reviewed. Percent stenosis was compared to the arm-leg blood pressure gradient as obtained from chart review, the depiction of collaterals by gadolinium-enhanced magnetic resonance angiography (MRA), and the percent increased flow in the distal thoracic aorta as measured by velocity-encoded cine MRI. Some imaging series or blood-pressure values were not available in some patients. All of the data were available for 15 of the 19 patients. RESULTS: The arm-leg blood pressure gradient showed no statistical association with percent stenosis (R(2) = 0.10, P = 0.22), direct visualization of collaterals (P = 0.80), or percent increase in flow (R(2) < 0.01, P = 0.85). Percent stenosis did show association with visualization of collaterals (P = 0.01) and increase flow (R(2) = 0.62, P < 0.01). CONCLUSION: The arm-leg blood pressure gradient is not a reliable indicator of hemodynamic significance of restenosis in patients with prior repair of CoA. Direct visualization of collateral vessels by MRA and percent increase in flow from proximal to distal descending thoracic aorta are reliable indicators of hemodynamic significance.

Adult↗