Clinical Significance of Recruitable Collatera Vessels in Coronary Artery Disease Ikuo Moriuchi 1 , Sumio Mizuno 1 , Yoshihumi Takahashi 1 , Kazuo Ohsato 1 , Tatsuaki Murakami 1 , Kensho Konishi 1 , Yoshiyuki Arai 1 , Kazunori Kanamori 1 1The Department of Internal Medicine, Fukui Cardiovascular Center Keyword: 潜在性側副血行 , PTCA , 対側造影 , 再狭窄 , recruitable collaterals , contralateral injection , restenosis pp.1013-1017
Published Date 1995/10/15
DOI https://doi.org/10.11477/mf.1404901134
  • Abstract
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In angioplasty, contralateral injection during balloon inflation can detect collateral vessels not spontaneously visible (recruitable collateral vessels). This study investigated the clinical significance of recruitable col-lateral vessels in coronary artery disease. AMI (acute myocardial infarction, n=31), OMI (old myocardial infarction, n=19) and AP (angina pectoris, n=23) were studied during the first successive balloon dilatation for single left anterior descending coronary artery stenosis. All subjects were male. In all subjects, good collaterals (Rentrop grade 2 or 3) were found in 9 patients (29%) with AMI, 10 patients (53%) with OMI and 14 patients (61%) with AP, while poor collaterals (Rentrop grade 0or1) were found in 22 patients (71%) with AMI, 9 patients (47%) with OMI and 9 patients (39%) with AP. Chest pain in patients with poor collaterals was more severe than that in patients with good collaterals. In the AP group, ST elevation on the intracoronary electrocardiogram to the occlusion site was 7.5±3.7mm in those with poor collaterals, and 4.1±3.2mm in those with good collaterals (p<0.05). In the AMI group, max CPK did not significantly differ whether the patients had poor or good collaterals. However in the OMI group, max CPK in the patients with poor collaterals was greater than that of those with good collaterals (p<0.05). Comparing patients in the AMI group before and after PTCA, LVEF (left ventricular ejection frac-tion) increased significantly in patients with good col-laterals but did not change in those with poor collat-erals. The restenosis ratio after PTCA was higher in patients with good collaterals, especially in the OMI group but was not affected in those with poor collat-erals.

Conclusions; The results of this study suggest that good recruitable collateral vessels protect myocardial damage but may increase the restenosis ratio after PTCA. This study supports the utility of contralateral injection during balloon inflation in angioplasty.

Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.


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