3 research outputs found
RELATION BETWEEN CHANGES IN BLOOD-FLOW OF THE CONTRALATERAL CORONARY-ARTERY AND THE ANGIOGRAPHIC EXTENT AND FUNCTION OF RECRUITABLE COLLATERAL VESSELS ARISING FROM THIS ARTERY DURING BALLOON CORONARY-OCCLUSION
Objectives. The purpose of this study was to investigate changes in the
magnitude of blood flow through the contralateral coronary artery in
relation to the development of recruitable collateral vessels arising
from this artery to supply a balloon occluded coronary vessel.
Background. Recruitable collateral vessels have been shown to emerge
suddenly to supply an occluded coronary artery, but their physiologic
effect cannot always be predicted angiographically.
Methods. Twenty four patients were studied during four successive
balloon dilations for single left anterior descending coronary artery
stenosis. Before and during each balloon occlusion, blood flow in the
proximal right coronary artery was measured by intracoronary Doppler
flow velocimetry and quantitative coronary angiography. Estimates of
chest pain and ST segment elevation were also obtained.
Results. Fourteen patients developed angiographically visible
recruitable collateral vessels (high grade in 6 [group III], low grade
in 8 [group II]), whereas 10 patients (group I) did not. During the
four successive balloon occlusions, the right coronary artery how showed
transient reproducible increases in group In (first occlusion 66.4 +/-
36.8%, fourth occlusion 64 +/- 23.9%, all p = 0.036), progressive
increases in group II (from first occlusion 17.9 +/- 26.6% [p = 0.08]
to fourth occlusion 60.4 +/- 35.9% [p = 0.014]) and no significant
changes in group I. Between the first and the fourth occlusion, the
severity of chest pain and the magnitude of ST segment elevation
declined significantly in group II but did not change in groups I and
III.
Conclusions. During balloon coronary artery occlusion, the transient
appearance of recruitable collateral vessels is associated with a
transient increase in blood flow through the collateral donor artery.
This increase in coronary flow appears to reflect collateral function
better than the angiographic assessment, especially in patients with
poor collateral vessel recruitment