Kober G, Schlinkbäumer M, Kaltenbach M
Z Kardiol. 1981 Oct;70(10):761-7.
The presence and quality of collaterals in coronary angiograms were studied in 89 patients with CHD before and after bypass surgery as well as in 12 unoperated patients who also underwent left heart catheterization twice. Total and local evaluation of collaterals was made in terms of global and regional collateral scores as well as collateral flow rates. Total revascularization generally leads to an entire disappearance of collaterals in the angiogram and represents a criterium for assessing the success of bypass surgery. In non-revascularized as well as unoperated patients, the quality of collaterals improves. This is attributable to additional surgically induced changes in the coronary arteries and progression of the underlying disease, respectively. Partially revascularized patients display no definite changes in total collateral score. In these cases, collaterals to the revascularized regions diminish, whereas those to non-revascularized regions increase. Myocardium not revascularized directly by an aortocoronary bypass graft is thus indirectly revascularized via the secondary appearance of collaterals, which enhance regional perfusion.
对89例冠心病患者在搭桥手术前后的冠状动脉造影中侧支循环的存在情况和质量进行了研究，同时对12例未接受手术但也接受了两次左心导管检查的患者进行了研究。根据整体和区域侧支循环评分以及侧支循环血流速度对侧支循环进行了全面和局部评估。完全血运重建通常会导致血管造影中侧支循环完全消失，这是评估搭桥手术成功与否的一个标准。在未进行血运重建的患者以及未接受手术的患者中，侧支循环的质量有所改善。这分别归因于冠状动脉额外的手术诱导变化和基础疾病的进展。部分血运重建的患者在总侧支循环评分上没有明显变化。在这些情况下，血运重建区域的侧支循环减少，而未血运重建区域的侧支循环增加。因此，未通过主动脉冠状动脉搭桥移植直接进行血运重建的心肌通过侧支循环的二次出现而间接实现血运重建，从而增强区域灌注。
