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At least 1,153 records · Page 64Linked to original sources
PubMed1984

Development of collateral circulation following distal embolization of hepatic artery in pigs.

The distal hepatic artery was embolized with black polystyrene microspheres (diameters of 50 +/- 10 mu and 200 +/- 25 mu) in 12 pigs. The animals were reexamined from 1 h to 2 weeks after embolization via hepatic angiography and subsequent injection of Microfil, a silicone rubber compound, into the arterial and portal vascular systems of the liver. Dissection of dehydrated and cleared liver specimens under the stereomicroscope demonstrated the presence of arterial collaterals bypassing embolized vessels within 2-3 days after embolization. Collaterals were noted to develop around occlusions in arteries with inner diameters as small as 100 mu.

Angiography↗
PubMed2003

Pulmonary vein thrombosis after bilobectomy and development of collateral circulation.

Pulmonary vein thrombosis is a rare but potentially life threatening complication following lobectomy or bilobectomy. We present a case of right upper pulmonary vein thrombosis after a middle and lower lobectomy diagnosed at transoesophageal echocardiography. The patient was treated with antibiotics and anticoagulation with good recovery. Pulmonary angiography was performed 35 days after surgery and revealed the venous return of the right lung through the intercostal veins. Despite double venous drainage of the lungs consisting of bronchial and pulmonary veins, pulmonary to systemic collaterals following pulmonary vein thrombosis have not previously been reported. The development of this shunt can prevent gangrene, and surgical resection of the lung segment involved can be avoided.

Adult↗
PubMed1976

[The effect of the collateral circulation on the total and regional myocardial function in coronary disease].

The cinecoronarograms, ventriculograms and electrocardiograms of 164 consecutive patients (32 patients without heart disease and 132 patients with coronary artery disease) have been analyzed. Total left ventricular function was assessed by the ejection fraction. Regional myocardial function was determined by a system of hemiaxes. 89 patients with complete obstruction of the right coronary artery (RC) and/or the anterior descending branch of the left coronary artery (LAD) were divided into subgroups with good, poor and no coronary collaterals. Total and regional left ventricular function was normal in patients with well collateralized coronary occlusions. Patients with poorly collateralized or non-collateralized occlusions had impaired left ventricular function. Patients with poorly collateralized coronary occlusions showed no difference in left ventricular function when compared to patients with coronary occlusions without collaterals. Combined occlusions of the RC + LAD without collaterals were not found. Good coronary collaterals have a protective effect on total and regional myocardial function, thus improving the prognosis in complete coronary artery obstruction.

Cardiac Output↗
PubMed1991

[Effect of collateral circulation on the progression of left ventricular dilatation after myocardial infarct].

48 patients (aged 50.5 +/- 8.5 years) with proven acute first myocardial infarction underwent coronary angiography 1.6 weeks to 4 years (mean 13.3 weeks) after infarction. No reperfusion interventions were performed, no patient received a longterm therapy with diuretics, glycosides, beta-blockers or ACE-inhibitors. In accordance with the angiographic results, patients were divided into two groups: 25 patients demonstrated a proximal occlusion of one major coronary artery with retrograde contrast filling by non-compromised collaterals; in 23 patients no collateral filling of the distal vessel segment was visible. The contralateral coronary arteries and corresponding LV wall segments were normal. Age, sex distribution, localization of the infarction and infarct related vessel and intraventricular pressures (LVSP = 121.2 +/- 13.5 vs. 122.1 +/- 18.9 mm Hg; LVEDP = 13.1 +/- 5.2 vs. 11.9 +/- 4.1 mm Hg) were not significantly different between both groups. Between both groups patients were compared in whom angiography was performed less than 4, 4-6, and greater than 6 weeks after infarction. In addition, occlusion of the LAD was compared with LCX- and RCA-obstructions both with and without collaterals. Patients with collaterals revealed no significant time dependent changes of the endsystolic (48.1 +/- 11.3; 56.7 +/- 20.5; 43.8 +/- 16.2 ml/m2), enddiastolic (114.9 +/- 30.6; 121.3 +/- 10.8; 99.0 +/- 22.5 ml/m2) volumes and ejection fraction (57.7 +/- 6.5; 53.9 +/- 13.5; 56.4 +/- 9.9%). In contrast in patients without collaterals ESVI increased significantly (44.2 +/- 16.2; 50.8 +/- 17.5; 68.3 +/- 30.9 ml/m2) by an exponential function (y = 28.11 e0.13x; r2 = 0.99; p less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed1995

Effect of propranolol on portosystemic collateral circulation estimated by per-rectal portal scintigraphy with technetium-99m pertechnetate.

BACKGROUND/AIMS: Propranolol is widely used in the prevention of variceal bleeding. However, in certain patients with cirrhosis, the portal hypotensive effect of propranolol cannot be obtained. An explanation for portal unresponsiveness to propranolol could be an increase in portocollateral vascular resistance mediated by this drug. METHODS: In 33 patients with cirrhosis the effect of chronic administration of propranolol on portocollateral blood flow from the inferior mesenteric vein was examined by means of per-rectal portal Tc-99m pertechnetate scintigraphy. RESULTS: Propranolol significantly reduced the shunt index by 15.3 +/- 4.2%. This reduction was observed only in patients with cirrhosis classified as Child-Pugh A and B groups, but not group C. Differences between groups in portosystemic shunt index changes after propranolol were significant (F = 3.4, p < 0.05). CONCLUSIONS: The data presented suggest that propranolol changes the distribution of blood between the portal and systemic circulation, which is probably due to the increase in vascular resistance of portocollateral vessels. The magnitude of the vascular response to propranolol depends on the severity of liver disease.

Adolescent↗
PubMed1985

Regional ischemia due to compromised collateral circulation after arterial reconstruction.

Two cases of severe regional ischemia following aorto-femoral-popliteal vascular reconstruction are presented. Partial necrosis of the gluteal musculature occurred in one of the patients. Total necrosis of the proximal part of the thigh and the gluteal region developed in the other patient, despite preserved blood supply to the distal part of the leg. The available literature contains no previous reports of necrosis of musculature and skin from such cause. On the basis of these cases, the importance of preserving the pelvic-femoral collaterals, viz. rectal artery anastomosis and Hunterian anastomosis, is emphasized. Sufficient pelvic-femoral collaterals presumably account for the low incidence of gluteal claudication following aortofemoral bypass surgery.

Aorta, Abdominal↗
PubMed1978

Myocardial infarction in the baboon: regional function and the collateral circulation.

Occlusion of the anterior descending coronary artery was produced in sedated baboons 7-15 days after implantation of a micromanometer and ultrasonic crystals for measurement of regional left ventricular dimensions in ischemic, marginal, and control segments. One minute after coronary occlusion (CO), ischemic segments exhibited a marked systolic bulge with wall thinning, and percent systolic shortening of marginal segments decreased. Over the ensuing weeks, there was a progressive increase of end-diastolic lengths in marginal and ischemic segments, whereas systolic shortening in these segments did not improve significantly. Control segments did not change. In control baboons, the coronary collateral index was 55 +/-25 (SE) compared to 560 +/- 74 in normal dogs. One month after CO, the collateral index was 543 +/- 144 in baboons compared to 6,685 +/- 716 in dogs, regions of normal tissue were seen in the infarct (14.2 +/- 2% of left ventricular mass). Minimal coronary collateral development in the baboon provides a likely explanation for differences from the dog in regional functional responses and in the character of the infarct.

Animals↗
PubMed1979

Coronary collateral circulation as an important factor to modify the ischemic injury of the myocardium in coronary ligated dogs.

Effect of coronary ligation on epicardial and intramyocardial ST-segment voltage was investigated in 121 dogs. After ligation of the anterior descending coronary artery, marked ST-elevation, more than 2 mV, was detected in 102 dogs (Group-I) in epicardial lead of the area which was nourished by the ligated coronary artery. In 7 dogs (Group-II), coronary ligation produced negligible changes in ST-segment voltage in epicardial lead, while significant ST-elevation was observed in the leads of middle and inner layers of the myocardium. Systemic hemo-dynamic parameters showed no statistically significant difference between the 2 groups. Coronary collateral indices, however, revealed the significant difference between them. Systolic peripheral coronary pressure was 29.3 +/- 3.1 mmHg in Group-I and 59.2 +/- 10.6 mmHg in Group-II (P less than 0.05). Retrograde flow was also greater in Group-II (14.8 +/- 4.4 ml/min) than in Group-I (1.3 +/- 0.5 ml/min) (p less than 0.01). Diversion of retrograde flow produced a marked ST-elevation in Group-II. Restoration of retrograde flow to the myocardium immediately decreased the ST-segment voltage. These results suggest that spontaneously developed collaterals have an important function for the prevention of the occurrence of ischemic injury after coronary ligation in dogs.

Animals↗
PubMed1982

Subendocardial versus transmural myocardial infarction: relationship to the collateral circulation in canine and porcine hearts.

In the present study, the relationship between transmural perfusion gradients and myocardial infarct size and distribution in canine and porcine hearts was characterized. Anesthetized pigs (N = 6) and dogs (N = 7) underwent a 2-h occlusion and 5-h reperfusion of the distal third of the left anterior descending coronary artery. The area at risk for infarction and ultimate infarct size were determined by fluorescein dye infused intracoronary and nitro blue tetrazolium stain, respectively. Myocardial perfusion within normal, ischemic, and infarcted regions was determined by the radioactive microsphere technique in each species. In dogs, infarction was subendocardial and comprised 29.9 +/- 5.5% of the area at risk, while in pigs infarction was transmural and comprised 50.1 +/- 4.2% (p less than 0.05). Collateral perfusion of the subendocardium of infarcted regions in pig and dog hearts was similar (0.05 mL X min-1 X g-1), while flow to the subepicardium was significantly (p less than 0.05) higher in dogs than in pigs (0.25 versus 0.05 mL X min-1 X g-1). The data demonstrate that species differences in myocardial infarct size and shape are related to differences in coronary collateral blood flow. The smaller subendocardial infarction in dog hearts is related to a relatively high subepicardial perfusion and transmural infarction in pig hearts owing to the lack of collateral perfusion in subepicardium as well as subendocardium.

Animals↗
PubMedDate not supplied

Interruption of the arterial inferior alveolar flow and its effects on mandibular collateral circulation and dental tissues.

The interruption of circulation through the inferior alveolar artery was followed by the establishment of a fast retrograde blood flow through the vessel. The mental artery and the mandibular branch of the sublingual artery were the main vessels to contribute to that flow. No histopathologic changes were found in the experimental hemimandibles; however, temporary regressive changes were found in the dental pulps of molars.

Angiography↗
PubMed1996

Effects of cardiac contraction and coronary sinus pressure elevation on collateral circulation.

Controlled coronary sinus occlusion was shown to retard necrosis of ischemic myocardium. To elucidate this mechanism, regional myocardial blood flow measurement was performed with and without coronary sinus pressure elevation to 30 mmHg (CS30). Colored microspheres were injected into left and right coronary arteries after coronary perfusion of the left anterior descending (LAD) coronary artery was stopped in seven isolated canine hearts with induced atrioventricular block, either paced at 120 beats/min by direct right ventricular stimulation [beating heart (B)] or during asystole induced by stopping pacing [nonbeating heart (NB)]. Regional myocardial blood flow in the LAD perfused area in the control state in the NB with normal coronary sinus pressure (NB-CScont; 0.27 +/- 0.13 ml.min-1.g-1, means +/- SE) was significantly greater than those in B-CScont (0.19 +/- 0.09 ml.min-1.g-1; P < 0.05) and in NB with CS30 (NB-CS30; 0.19 +/- 0.09 ml.min-1.g-1; P < 0.05). Regional myocardial blood flow of the LAD area in B with CS30 (B-CS30; 0.23 +/- 0.10 ml.min-1.g-1) was significantly greater in comparison with that at B-CScont and NB-CS30 (P < 0.05). The augmentative effect of the LAD area regional myocardial blood flow was observed only in the periphery of the ischemic region but not in its center. Cardiac contraction and CS30 impede regional myocardial blood flow in the ischemic bed independently. The coexistence of these two factors enhances regional myocardial blood flow. In conclusion, coronary sinus pressure elevation in B may participate in augmenting collateral flow.

Animals↗
PubMed1976

[Postmortem demonstration of portal vein collateral circulation (author's transl)].

INTRODUCTION: Postmortem investigation of esophageal varices and the portal system is difficult, because veins are collapsed at autopsy. The demonstration of varices is possible by illumination of the isolated mucous membrane or by puncturing esophageal varices and filing them with different materials. MATERIAL AND METHODS: We use a 15% aqueous gelatine solution (if needed with additional barium sulfate for x-ray examination) which is supplemented by 40% formaldehyde (40 ml in 1 1 gelatine solution). The superior mesenteric vein is catheterized and filled by a clyster-pump. RESULTS: The mixture of gelatine and formaldehyde hardens within a few minutes. The autopsy is delayed only about half an hour. Within this time the portal system is well outlined. This method can show exactly the drainage of the portal system into the inferior vena cava. In cases of portocaval shunt or of esophageal transsection the result of the operation can be verified. The localization of the bleeding source of esophageal varices can be demonstrated by escape of the filling mass.

Autopsy↗
PubMed2003

[Collateral circulation of the left colon: historic considerations and actual clinical significance].

INTRODUCTION: The arterial communication between the superior and inferior mesenteric arteries is important in surgery of the colon and aorta. METHODS: The anastomosis between the median colic artery (ACM) and the superior colic artery (AMS) was studied on 52 cadavers (32 female, 20 male). The length of the artery was measured using a flexible scale, and its diameter was determined at three different locations (origin, middle, end). RESULTS: The median lengths of the arteries were: 6.8 cm (range 3.9-9.7) for ACM, 12.2 cm (range 7-17.4) for ACS, and 23 cm (range 13.6-34.2) for margin artery. The median diameters were: 3.4 mm (range 2.7-4.1) for ACM, 3.1 mm (range 2.1-4.1) for ACS, and 2.7 mm (range 2-3.4) for margin artery. In 9.6% of the cadavers ( n=5), additional anastomoses between the AMS and inferior mesenteric arteries were proven. In 90.4% ( n=47), only margin arteries were found. SUMMARY: The low incidence of an additional communication (Riolan's arch) and possible additional impairment of the blood supply should be taken into account during operation.

Angiography↗
PubMed1984

[Hemo- and lymphomicrocirculatory bed of the broad ligament of the uterus in the presence of collateral circulation].

Structural adaptation of the vascular bed in the broad ligament of the dog uterus has been studied at various time of the experimental phlebohypertension. Restitution of the circulation after the posterior vena cava occulsion occurs phasically. The venous collateralies are not formed at one time and it is connected with the venous pressure level in the inferiocaval system and with some changes in the construction of the microcirculatory bed. Basing on the morphometry data, a general equation has been derived which reflects dynamics of the microangiological parameters and demonstrates unidirectionness of the adaptive reactions in the vascular bed at the disturbed venous circulation. Using principles of the system-structural analysis and the mathematical graph theory, we consider the microcirculatory system of the broad ligament of the uterus as a graph-system and study the reorganization of the microcirculatory network at a venous congestion. Realization of the compensatory possibilities is reached in the microcirculatory bed by a changed relationships in the number of the intervascular connections. The latter are estimated according to the graph-schemes of the microvascular bed. Morphokinetics of the connections between the vessels is characterized by widening or narrowing the borders of the "adaptive norm" and by changing the microangioarchitectonics. At the same time, there is noted formation of specialized microhemoangioconstructions. Morphofunctional state of the lymphatic system is connected with reorganization of the angioarchitectonics. This is certain manifestation of the law of the lymphatic and blood beds "synergism". Thus, the structural changes of the vascular bed are aimed to support a certain hemodynamic level.

Animals↗
PubMed2002

Collateral circulation is an independent radiological predictor of outcome after thrombolysis in acute ischaemic stroke.

We tested the hypothesis that the type of vascular occlusion, recanalisation and collateralisation are predictive of outcome after thrombolytic therapy in acute ischaemic stroke. We carried out angiography and local intra-arterial (97) or systemic (14) thrombolysis within 6 h of the onset in patients with an ischaemic stroke in the territory of the internal carotid artery. Early ischaemic signs (EIS) on pretreatment CT and angiographic findings were classified and analysed in relation to clinical outcome at 3 months. A favourable outcome (Barthel index [BI]>/= 90) was found in 40% of patients with an occlusion of the middle cerebral artery trunk whereas intracranial occlusion of the internal carotid artery ("carotid T occlusion") was followed by death or severe disability (BI<50) in 87%. Significant univariate predictors of favourable outcome were occlusion type ( P<0.01), recanalisation ( P<0.01) and collateralisation ( P<0.01). However, multivariate analysis revealed a significant relationship only between collateralisation and favourable outcome (odds ratio 5.9, 95% confidence interval 1.3-26.7, P=0.02). EIS were not predictive in either case. Occlusion type and recanalisation, are related to outcome only if adequate collateralisation prevents infarction until recanalisation occurs.

Acute Disease↗
PubMed1962

The effect of persantin on intercoronary collateral circulation and survival during gradual experimental coronary occlusion. A preliminary report.

Twenty-five dogs were exposed to gradual coronary occlusion by placing Ameroid constrictors around the origins of the left circumflex and anterior descending coronary arteries. Previous experiments have demonstrated that these constrictors absorb water and, over a period of three weeks, narrow the cross-sectional area of the two arteries to 50% or less, and consequently cause the death of 80% of the experimental animals. Twelve of the 25 animals were fed 50 mg. of Persantin three times a day by mouth commencing one day before the operative procedure. Determinations of the concentration of the drug in the blood revealed a level consistent with that obtained in humans after the administration of therapeutic doses. Eleven of the 13 control animals died in the three-month experimental period while only six of the 12 treated animals expired. Injections of Schlesinger mass in all animals dying or killed following the experimental period demonstrated that Persantin significantly accelerated the development of intercoronary anastomoses in the treated group, and in the surviving animals produced a rich anastomotic network much in excess of that seen in the surviving animals in the control series that were exposed to hypoxia alone. On the basis of these experimental findings, it is suggested that Persantin may favourably alter the prognosis of many patients with coronary artery disease.

Animals↗