Department of Cardiology, Medizinische Universitätsklinik, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland.
Cardiology Department, Heart Institute "Niculae Stancioiu", University of Medicine and Pharmacy "Iuliu Hatieganu", Motilor 19-21, 400001, Cluj-Napoca, Romania.
Eur Heart J. 2023 Aug 7;44(30):2805-2814. doi: 10.1093/eurheartj/ehad327.
The colorful term "coronary steal" arose in 1967 to parallel "subclavian steal" coined in an anonymous 1961 editorial. In both instances, the word "steal" described flow reversal in the setting of an interconnected but abnormal vascular network-in one case a left subclavian stenosis proximal to the origin of the vertebral artery and in the other case a coronary fistula. Over time, the term has morphed to include a larger set of pathophysiology without explicit flow reversal but rather with a decrease in stress flow due to other mechanisms. This review aims to shed light on this phenomenon from a clinical and a pathophysiological perspective, detailing the anatomical and physiological conditions that allow so-called steal to appear and offering treatment options for six distinct scenarios.
“冠状窃血”这一形象的术语出现于 1967 年,与 1961 年一篇匿名社论中创造的“锁骨下窃血”相呼应。在这两种情况下,“窃血”一词都描述了在相互连通但异常的血管网络中血流方向的逆转——一种情况是左锁骨下动脉狭窄位于椎动脉起源部的近端,另一种情况是冠状动脉瘘。随着时间的推移,该术语已逐渐演变为包括一组更大的病理生理学机制,而不涉及明确的血流逆转,但由于其他机制导致压力血流减少。这篇综述旨在从临床和病理生理学角度来阐明这一现象,详细描述了允许出现所谓窃血的解剖学和生理学条件,并为六种不同的情况提供了治疗选择。