Watarai M, Takatsu F, Shimizu S, Nishiyama A, Shiga Y, Furuta T
Department of Internal Medicine, Anjo Kosei Hospital, Aichi, Japan.
Jpn Heart J. 1992 Sep;33(5):643-51. doi: 10.1536/ihj.33.643.
The clinical significance of collaterals visible on angiography immediately after successful percutaneous transluminal coronary angioplasty (PTCA) was analyzed in 221 patients who underwent successful PTCA for coronary arteries receiving collaterals. Filling of the collaterals was classified as good; filling the entire epicardial segment of the stenosed site, fair; partially filling the epicardial segments distal to the stenosed site, and faint; visible but not filling the epicardial segments of the diseased vessel. Fifteen of 41 good collaterals remained good or fair on angiography immediately after PTCA. Among the 114 fair collaterals, 26 remained fair and 20 of 66 faint collaterals remained visible on the angiogram immediately after PTCA. There was no relationship between the degree of residual stenosis after PTCA and the degree of residual collaterals. Repeat coronary angiography was obtained in 156 patients. There was no correlation between the presence, absence or degree of collaterals observed on angiography immediately after successful PTCA and the rate of restenosis. Thus, collaterals to the vessels dilated by PTCA often remain on the angiogram immediately after PTCA and are dependent primarily on their degree before dilation. They do not indicate inadequate dilation or predict restenosis.
对221例接受经皮腔内冠状动脉成形术（PTCA）成功且冠状动脉有侧支循环的患者，分析PTCA成功后即刻血管造影可见侧支循环的临床意义。侧支循环的充盈情况分为良好，即充盈狭窄部位的整个心外膜段；中等，即部分充盈狭窄部位远端的心外膜段；微弱，即可见但未充盈病变血管的心外膜段。41例良好侧支循环中有15例在PTCA后即刻血管造影时仍为良好或中等。在114例中等侧支循环中，26例仍为中等，66例微弱侧支循环中有20例在PTCA后即刻血管造影时仍可见。PTCA后残余狭窄程度与残余侧支循环程度之间无相关性。156例患者进行了重复冠状动脉造影。PTCA成功后即刻血管造影观察到的侧支循环的有无或程度与再狭窄率之间无相关性。因此，PTCA扩张血管的侧支循环在PTCA后即刻血管造影时常仍可见，且主要取决于扩张前的程度。它们并不表明扩张不足或预测再狭窄。
