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Results for “Collateral Circulation”

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At least 19 recordsLinked to original sources
PubMed2025

Distinct immune-metabolic phenotypes underlie poor coronary collateral circulation.

BACKGROUND: Coronary collateral circulation (CCC) significantly impacts myocardial perfusion and clinical outcomes in coronary artery disease patients, yet the underlying molecular heterogeneity remains inadequately characterized. OBJECTIVE: To identify distinct molecular phenotypes in patients with poor CCC, validate these phenotypes using clinical parameters, and evaluate their prognostic implications. METHODS: This study enrolled 149 patients (80 with good CCC and 69 with poor CCC) for high-throughput proteomic profiling. Unsupervised consensus clustering identified molecular subtypes within poor CCC patients, followed by differential expression analysis and KEGG pathway enrichment. Boruta feature selection was implemented, and multiple machine learning algorithms were tested on clinical data, with XGBoost optimization (accuracy 80.0%, F1-score 80.31%) and SHAP value interpretation. External validation was performed using the MIMIC database. Kaplan-Meier analysis and Cox regression models assessed major adverse cardiovascular events (MACE). RESULTS: Two distinct phenotypes emerged among poor CCC patients: Cluster 1 (n&#x2009;=&#x2009;39, Complement-Driven Vascular Remodeling [CDVR]) and Cluster 2 (n&#x2009;=&#x2009;30, Immuno-Thrombotic Myocardial Dysfunction [ITMD]). An XGBoost model incorporating fasting glucose, eosinophil percentage, and HbA1c achieved excellent discrimination (AUC&#x2009;>&#x2009;0.91). External validation confirmed the phenotype-specific clinical patterns. Notably, Cluster 2 demonstrated significantly higher MACE incidence compared to Cluster 1 (Log-rank p&#x2009;<&#x2009;0.05), with KEGG analysis revealing significant upregulation of platelet activation, diabetic cardiomyopathy, and metabolic pathways in the ITMD phenotype. CONCLUSION: Poor CCC encompasses distinct immune-metabolic phenotypes that can be accurately classified using integrated proteomic-clinical modeling. This classification enables more precise risk stratification and may guide personalized therapeutic strategies for coronary artery disease patients with inadequate collateralization.

Humans↗
PubMed1978

Infarction and circulation in cerebrum. Effect of recanalization and/or collateral circulation on the lesion and prognosis.

Findings of computed tomography (CT) and angiography in supratentorial cerebral infarction associated with complete stroke were compared with regard to prognosis. It was found that the extent of low-density areas on CT was perfectly in accordance with the areas of occluded arteries on angiograms. However, the low-density areas on CT were always smaller than the areas involved angiographically when early recanalization and/or collateral circulation were carried out within 2 to 3 days of onset. It was also found that smaller low-density areas only had favorable effect. We concluded that the prognosis was better with early recanalization and/or collateral circulation, despite the general acceptance of its poor prognostic implication.

Adult↗
PubMed1978

The behavior of collateral circulation after coronary artery bypass surgery.

The changes in coronary collateral circulation after bypass surgery were analyzed in 50 patients with coronary disease. The demonstration of collateral circulation was found to be dependent upon the severity of the coronary heart disease and the patency of the bypass. When the graft was patent, it was usually not possible to visualize the collateral circulation demonstrated preoperatively. When the bypass was occluded, the same collateral circulation as before surgery was frequently found.

Collateral Circulation↗
PubMed1978

[Coronary collateral circulation in coronary atherosclerosis (author's transl)].

The coronary collateral circulation of 162 patients suffering from atherosclerosis and coronary insufficiency (coronary artery disease) was studied. It was found to be present in 44 patients, or 27.1%; homocoronary in 9%, intercoronary in 90.9%. As other Authors have previously reported, anastomotic circulation is more developed when the coronary occlusion exceeds 75%. Not one of the 44 cases with normal coronary arteries or occlusion inferior to 75% presented collateral circulation. In addition, it was found to be present more frequently in cases with three branch lesions. The time of insurgence of coronary insufficiency seems to condition the development of anastomotic circulation which appears more frequently when the symptoms have been present for more than 5 years (43.9%). Anastomotic circulation is also found more frequently (48.4%) in patients who have suffered myocardial infarction and who have angina. Collateral circulation was not found in any of the 46 patients with unstable isolated angina; this seems to show the importance, in its pathogenesis, of the functional factor (spasm). In conclusion, we may say that anastomotic circulation is more developed: 1) in cases of severe occlusive lesions (in severe coronary occlusive disease/atherosclerosis) (85%);2) in three branch lesions; 3) in cases of long standing symptomatology; 4) in stable angina and in angina t infarction.

Angina Pectoris↗
PubMed1979

Collateral circulation and stealmechanisms in innominate and subclavian artery obstruction.

Various types of collateral circulation and of intra- and extracerebral stealmechanisms have been described during the past two decades. The object of this short report is to discuss the clinical-angiographic data of two patients with extracranial cerebro-vascular occlusion, also in relation with current literature. Two case histories are described. The first showed a double extracerebral steal plus intracerebral interhemispheric steal, due to innominate artery obstruction. The second had only a external vertebral collateral circulation due to proximal subclavian occlusion. The factors which precipitate collateral circulation to steal are discussed.

Aged↗
PubMed1979

Collateral circulation in stenosis or occlusion of the renal artery.

The abdominal angiograms of 381 patients were critically reexamined for the existence of collateral circulation in cases of renal artery stenosis or occlusion. Typical renal artery stenosis was found in 39 patients; among these, 17 had a collateral circulation, which was extrarenal in 15 and intrarenal in two. Collateral circulation involving the lumbar arteries was most common. In two patients a collateral circulation was established via the inferior mesenteric artery.

Adolescent↗
PubMed1979

Functional effect of collateral circulation after dearterialization of the liver.

The functional effect of the collateral circulation after hepatic dearterialization was investigated in dogs with end-to-side protacaval shunt after ligation of hepatic artery. The functional effect of collateral circulation was far less than that of the native hepatic artery even for one week after occlusion of the common hepatic artery. However the functional effect of the collateral blood flow suddenly rose to the level of that of native hepatic artery one week after ligation of common hepatic artery or two weeks after ligation of proper hepatic artery.

Animals↗
PubMed1978

[Umbilical collateral circulation in liver cirrhosis - Cruveilhier-v. Baumgarten syndrome (author's transl)].

Embryonal development and anatomy of the liver are shortly discussed; they do explain collateral circulation in liver cirrhosis. A case report is given of a patient with umbilical collateral circulation (Cruveilhier-v. Baumgarten syndrome), exhibiting impressive clinical and radiological findings. Such an umbilical collateral circulation will develop in up to 21% of all patients with an intrahepatic block. This is only one variant - not prone to complications by the way - of a multitude of different portosystemic shunts in liver cirrhosis. Therefore it should not be talked about as an independent syndrome.

Collateral Circulation↗
PubMed1979

[The collateral circulation due to cerebral arterio-venous malformation and occlusions of major cranial vessels (author's transl)].

Arteriovenous malformations (AVM) of the brain are diagnosed mostly in the early adult life. With the come up of Computerized Tomography (CT) which often is done without the strong indications as postulated for the conventional neuroradiologic examinations, asymptomatic AVM in the elderly population may be found. Since May 1977 4 asymptomatic arteriovenous malformations were diagnosed in our institution using CT. 2 of these patients had severe degenerative changes of the great cerebral vessels and an unusual collateral circulation developed probably because of the steal-phenomenon in the vascular malformation. These 2 cases allow to study all possibilities of cerebral collateral circulation. Uncommon in one of the cases was a capillary anastomotic network through the thalami, in the other case an extensive dural rete mirabile developed. The problems of collateral circulation are discussed.

Cerebral Angiography↗
PubMed1979

Collateral circulation in the rabbit tongue after common carotid ligation.

A study was undertaken to ascertain the microvascular pattern of the collateral circulation of the tongue after unilateral ligation of the common carotid artery. The right common carotid artery was ligated in 25 New Zealand White male rabbits. These animals were killed in groups of five at intervals of an hour, six hours, 24 hours, one week, and two weeks. The vasculature in the head and neck of these animals was flushed with heparinized saline solution and perfused with latex. The results show that circulation was present but signifincatly reduced in the one-hour group, slightly reduced in the six-hour and 24-hour groups, and normal in the one- and two-week groups. This study indicates that the collateral circulation of the tongue is extensive and that a normal vascular pattern returns within a week after unilateral ligation of the common carotid artery.

Animals↗
PubMed1979

[Chronic occlusion of a renal artery with aneurysms in the para-aortic collateral circulation and multiple aneurysms in both kidneys (author's transl)].

Chronic occlusion of the main renal artery may be followed by the development of a collateral circulation through ureteric and para-aortic arteries, and through lumbar and suprarenal arteries. A patient with occlusion of the left main renal artery is described, who developed a collateral circulation between the common iliac artery and the distal portion of the renal artery. The para-aortic collateral vessel developed one large and several small aneurysms, and there were aneurysms in both kidneys.

Aneurysm↗
PubMed1977

Intrarenal collateral circulation in the pediatric patient.

The presence of an intrarenal collateral circulation in pediatric patients with segmental renal artery stenosis has not been stressed. Three patients demonstrating these collateral pathways are presented. The anatomy, pathogenesis, angiographic features, differential diagnosis, and significance of intrarenal collaterals in infants and children are discussed.

Adolescent↗
PubMed1976

Reappraisal of the functional significance of the coronary collateral circulation.

A review of data in 465 patients with complete obstruction of either the left anterior descending or right coronary artery was undertaken to evaluate the functional role of the collateral circulation. Complete obstruction of a dominant right coronary artery was observed in 288 patients, 83 percent with distal filling and visualization of the posterior descending artery by way of collateral vessels. Complete obstruction of the left anterior descending artery was noted in 177 patients, 71 percent with filling and visualization distal to the obstruction by way of collateral vessels. Among patients with obstruction of the left anterior descending artery, there was a significantly greater frequency of congestive heart failure and cardiomegaly in those without collateral vessels than in those with collateral vessels. The former also had a significantly greater frequency of both electrocardiographic evidence of an anterior wall myocardial infarction and angiographic findings of anterior wall asynergy. The frequency of inferior myocardial infarction and inferior wall asynergy was not influenced by the presence of collateral vessels. These observations indicate that the collateral circulation plays a significant protective role in the presence of obstruction of the left anterior descending artery, which is not apparent with obstruction of the right coronary artery.

Adult↗
PubMed1977

[Development of collateral circulation in the Paget-Schroetter syndrome].

An eleven years' clinical treatment of a 28-year-old tractor-driver with Paget-Schroetter's syndrome is described. The development of the collateral circulation was pursued during 6 years or 11 years, respectively, after the occurence of the vein thrombosis and the importance of phlebography in this rare disease is emphasized for the judgment of the prognosis. Phlebographic procedure is recommended for the reliable evaluation of the pathomorphological changes of the veins and of the developed collateral circulation.

Adult↗
PubMed1979

[Anatomical and physiological assessment of the collateral circulation in experimental femoral artery ligation in venous insufficiency].

Peculiarities of collateral circulation following isolated and combined ligations of the femoral vessels were studied in experiments on 62 dogs through physiologic and anatomic investigation methods. It has been shown that the ligation of the vein prevents the exsanguination of the limb, arising from an injury to the main artery, favours an accelerated anatomic reconstruction of the arterial collaterals, but increases microcirculatory disturbances, aggravates tissue ischemia and disorder of the acid-base balance, which as a whole evidences a detrimental effect of concomitant venous insufficiency upon the process of the restoration of the circulation in the limb.

Animals↗
PubMed1977

Collateral circulation after renal artery occlusion in the rat.

We used angiographic and microsphere methods to evaluate the anatomic and functional features of renal collateral circulation in the rat. By the microsphere method, renal parenchymal blood flow was less than 1% of control 1 hour after occlusion of the main renal artery; 2.8% of control 1-2 weeks after arterial occlusion; and 1% of control 4-9 weeks after occlusion. Radiographic observations during chronic occlusion revealed numerous collateral vessels to the kidney. These vessels readily filled with angiographic contrast medium but the intrarenal circulation did not visualize. We conclude that collateral circulation to renal parenchyma is negligible after acute or chronic occlusion of the main renal artery in the rat. The rich anatomic plexus of collateral vessels has no functional significance and is unable to preserve viability of the parenchyma.

Acute Disease↗
PubMed1979

Effects of theo-esberiven on the development of collateral circulation in dog hearts.

Effects of Theo-Esberiven, a coronary vasodilator, on the development of collateral circulation were investigated in dogs with their left anterior descending artery chronically occluded. The drug was administered i.v. at 0.1 ml/kg once a day for 1 to 4 weeks after the occlusion. Left circumflex coronary flow in dogs treated with the drug was increased over the value in control ones when measured one week after the occlusion. At the same time, the ratio of retrograde pressure to perfusion pressure, which correlates negatively with the collateral vascular resistance, significantly exceeded the value in control (P less than 0.05). On the basis of observations with blood vessel casts of hearts, distinct anastomoses between the circumflex and anterior descending arteries had already been observed in all preparations from dogs treated for 2 weeks in contrast to the findings seen in control ones. There were less histological changes in myocardial tissue obtained from dogs treated for one week than those in control ones. From these results, Theo-Esberiven appears possibly to accerelate the collateral development at the earlier stages after the coronary occlusion.

Aminophylline↗