Blood Flow Velocity in Donor Coronary Artery Depends on the Degree and Pattern of Collateral Vessel Development: A Study Using Thrombolysis in Myocardial Infarction Frame Count Method

Plamen Gatzov, Athanassios Manginas, Vassilis Voudris, Gregory Pavlides, Gencho D. Genchev, Dennis V. Cokkinos

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

To understand the influence of collateral vessels on the coronary flow, TIMI frame count (TFC) method was applied as a measure of mean coronary blood flow velocity in artery giving collateral blood supply to the other artery in angiograms of 76 patients with single occluded coronary artery: RCA giving collaterals to occluded LAD or LAD giving collaterals to occluded RCA. As a control group, TFC was applied in angiograms of 30 patients with mild or no coronary artery disease. TFC was lower (faster blood flow) in LAD giving collaterals to occluded RCA (43 patients) than in LAD in control group (21.8 ± 10.5 vs. 33.9 ± 20.8 frames; P < 0.01). Higher degree of collateral vessels (Rentrop classification) and mixed- and distal-type collaterals (through the interventricular septum and heart apex) was associated with lower TFC. There was no difference in TFC in the RCA giving collaterals to an occluded LAD (33 patients) compared to the TFC in RCA in control group (16.6 ± 9.0 vs. 18.5 ± 6.0; P = NS), even in angiograms with higher degree of collateral vessel development. TFC was lower (faster blood flow) only in subgroups with mixed (proximal and distal types together in the same patient) and distal (through the interventricular septum and the apex of the heart) collateral types. A delayed contrast appearance in occluded LAD compared to occluded RCA has been found (35.1 ± 16.1 vs. 20.2 ± 7.3 frames; P < 0.001) with earlier contrast appearance in occluded LAD when proximal collateral vessels (through the conal and acute marginal branches of RCA) were presented. The coronary flow in donor arteries depends not only on the degree but also on the pattern of collateral vessels. The simple TFC method may facilitate the study of collateral filling pattern and offer insight into the influence of collaterals on the ventricular function.

Original languageEnglish (US)
Pages (from-to)462-468
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume60
Issue number4
DOIs
StatePublished - Dec 2003

Keywords

  • Coronary collateral flow
  • Coronary steal
  • TIMI frame count

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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