Klein L W, Agarwal J B, Helfant R H
Philadelphia Heart Institute, Presbyterian-University of Pennsylvania Medical Center 19104.
Am Heart J. 1988 Mar;115(3):554-8. doi: 10.1016/0002-8703(88)90803-4.
It has been shown that collaterals can develop rapidly during acute coronary occlusion, either due to thrombosis or during angioplasty (PTCA). However, the fate of well-developed collaterals immediately after a successful PTCA is unknown. Accordingly, 15 patients with Rentrop class 2 or 3 collaterals as visualized angiographically were studied immediately after successful single-vessel PTCA. The left anterior descending artery contained the stenosis in nine patients and the right coronary contained the stenosis in six patients. There was total occlusion of six vessels and subtotal occlusions of nine vessels pre PTCA. Immediately after PTCA, flow through the collaterals to the stenosed artery could no longer be visualized angiographically in eight patients (group 1), but remained faintly visible in seven patients (group 2). There was no difference between these two groups with regard to pre PTCA transstenotic pressure gradient (46 +/- 12 vs 42 +/- 14 mm Hg), post PTCA pressure gradient (13 +/- 7 vs 11 +/- 10 mm Hg), or post PTCA percent luminal diameter narrowing (26 +/- 18% vs 24 +/- 13%). These findings suggest that despite similar hemodynamic and angiographic improvement, the resolution of collaterals immediately after PTCA is variable.
研究表明，在急性冠状动脉闭塞期间，无论是由于血栓形成还是在血管成形术（PTCA）过程中，侧支循环都可以迅速形成。然而，成功进行PTCA后，已充分发育的侧支循环的转归尚不清楚。因此，对15例经血管造影显示为Rentrop 2级或3级侧支循环的患者在成功进行单支血管PTCA后立即进行了研究。9例患者的左前降支存在狭窄，6例患者的右冠状动脉存在狭窄。PTCA前有6支血管完全闭塞，9支血管次全闭塞。PTCA后立即进行血管造影，8例患者（第1组）中通过侧支循环流向狭窄动脉的血流不再可见，但7例患者（第2组）中仍隐约可见。这两组在PTCA前跨狭窄压力梯度（46±12 vs 42±14 mmHg）、PTCA后压力梯度（13±7 vs 11±10 mmHg）或PTCA后管腔直径缩小百分比（26±18% vs 24±13%）方面没有差异。这些发现表明，尽管血流动力学和血管造影改善相似，但PTCA后立即侧支循环的消退情况是可变的。
