Coronary collaterals: Difference between revisions
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==Angiography Examples== | ==Angiography Examples== | ||
Shown below are an animated image and a static image depicting collateral artery between the | Shown below are an animated image and a static image depicting collateral artery between the [[RCA]] and the [[LAD]]. Outlined in yellow in the image on the right is the collateral artery. | ||
[[Image: | [[Image:RCA-to-LAD-case-2.gif|300px|Collateral artery between the RCA and the LAD]] | ||
[[Image: | [[Image:RCA-to-LAD-case-2-static.gif|300px|Collateral artery between the RCA and the LAD: Outlined in yellow in the image on the right is the collateral artery.]] | ||
==Additional Examples== | ==Additional Examples== | ||
Revision as of 04:07, 10 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 RCA and the LAD. Outlined in yellow in the image on the right is the collateral artery.
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.