Coronary collaterals: Difference between revisions
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==Overview== | ==Overview== | ||
Coronary collateral arteries bypass the blockage in the main artery and supply enough oxygenated blood to enable the cardiac tissue to survive and recover. | Coronary collateral arteries bypass the blockage in the main artery and supply enough oxygenated blood to enable the cardiac tissue to survive and recover. | ||
==Grading System== | ==Grading System== | ||
Angiographic assessment of apparent collaterals is useful to quantify the angiogenic response to interventions designed to enhance myocardial perfusion and function in ischemic myocardium.<ref>Fuchs S. Lack of correlation between angiographic grading of collateral and myocardial perfusion and function. Coron Ar Disease 2001; 12: 173-78.</ref> <ref>Abbott JD, Choi EJ, Selzer F, Srinivas VS, Williams DO Impact of Coronary Collaterals on Outcome Following PCI [from the NHLBI Dynamic Registry]. Am J Cardiol. 2005; 96: 676–680.</ref> <ref>Koerselman J, van der Graaf Y, de Jaegere PP, Grobbee DE. Coronary Collaterals an Important and Underexposed Aspect of Coronary Artery Disease. Circulation. 2003; 107: 2507-2511.</ref> Collateral Circulation is assessed visually using the following grading system: | Angiographic assessment of apparent collaterals is useful to quantify the angiogenic response to interventions designed to enhance myocardial perfusion and function in ischemic myocardium.<ref>Fuchs S. Lack of correlation between angiographic grading of collateral and myocardial perfusion and function. Coron Ar Disease 2001; 12: 173-78.</ref> <ref>Abbott JD, Choi EJ, Selzer F, Srinivas VS, Williams DO Impact of Coronary Collaterals on Outcome Following PCI [from the NHLBI Dynamic Registry]. Am J Cardiol. 2005; 96: 676–680.</ref> <ref>Koerselman J, van der Graaf Y, de Jaegere PP, Grobbee DE. Coronary Collaterals an Important and Underexposed Aspect of Coronary Artery Disease. Circulation. 2003; 107: 2507-2511.</ref> Collateral Circulation is assessed visually using the following grading system: | ||
====Grade 0: No collaterals present==== | |||
Angiography fails to reveal evidence of collateral vessels. | |||
====Grade 1: Partial Collaterals==== | |||
Partial collaterals are collaterals which fill branches of a major epicardial branch, but not the major [[artery]] itself. There is evidence of minimal to partial filling of the recipient branch epicardial arteries/infarct region. It is not necessary for one to see the branches connect directly to the major epicardial artery. | |||
====Grade 2: Complete Collaterals==== | |||
Complete collaterals are well-developed collaterals which fill into a major epicardial branch, regardless of whether dye reaches the lesion which is collaterized or not. Bridging collaterals, a subgroup of complete collaterals, arise from the culprit vessel and fill the major epicardial branch of the culprit vessel. | |||
====Grade 3: Myocardial Collaterals==== | |||
Myocardial collaterals are collaterals which participate in the perfusion of the [[myocardium]], but do not fill any visible arterial branch. | |||
==Angiography Examples== | ==Angiography Examples== | ||
Revision as of 15:57, 6 September 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2]; Rim Halaby, M.D. [3]
Overview
Coronary collateral arteries bypass the blockage in the main artery and supply enough oxygenated blood to enable the cardiac tissue to survive and recover.
Grading System
Angiographic assessment of apparent collaterals is useful to quantify the angiogenic response to interventions designed to enhance myocardial perfusion and function in ischemic myocardium.[1] [2] [3] Collateral Circulation is assessed visually using the following grading system:
Grade 0: No collaterals present
Angiography fails to reveal evidence of collateral vessels.
Grade 1: Partial Collaterals
Partial collaterals are collaterals which fill branches of a major epicardial branch, but not the major artery itself. There is evidence of minimal to partial filling of the recipient branch epicardial arteries/infarct region. It is not necessary for one to see the branches connect directly to the major epicardial artery.
Grade 2: Complete Collaterals
Complete collaterals are well-developed collaterals which fill into a major epicardial branch, regardless of whether dye reaches the lesion which is collaterized or not. Bridging collaterals, a subgroup of complete collaterals, arise from the culprit vessel and fill the major epicardial branch of the culprit vessel.
Grade 3: Myocardial Collaterals
Myocardial collaterals are collaterals which participate in the perfusion of the myocardium, but do not fill any visible arterial branch.
Angiography Examples
Shown below are an animated image and a static image depicting collateral artery between the OM and the PDA. Outlined in yellow in the image on the right is the collateral artery.
Collateral artery between the OM and the PDA
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Additional Examples
Click here for more examples of coronary collaterals.
References
- ↑ Fuchs S. Lack of correlation between angiographic grading of collateral and myocardial perfusion and function. Coron Ar Disease 2001; 12: 173-78.
- ↑ Abbott JD, Choi EJ, Selzer F, Srinivas VS, Williams DO Impact of Coronary Collaterals on Outcome Following PCI [from the NHLBI Dynamic Registry]. Am J Cardiol. 2005; 96: 676–680.
- ↑ Koerselman J, van der Graaf Y, de Jaegere PP, Grobbee DE. Coronary Collaterals an Important and Underexposed Aspect of Coronary Artery Disease. Circulation. 2003; 107: 2507-2511.