The haemodynamic effects of collateral donation to a chronic total occlusion: Implications for patient management

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:198

Article

Ladwiniec, Andrew¹  Hoye, Angela¹ 

[1] Castle Hill Hosp, Dept Acad Cardiol, Kingston Upon Hull HU16 5JQ, N Humberside, England

关键词: Chronic total coronary occlusion;    Collateral circulation;    Fractional flow reserve;    Coronary physiology;   

DOI  :  10.1016/j.ijcard.2015.06.174

来源: Elsevier

【 摘 要 】

Physiological lesion assessment in the form of Fractional Flow Reserve (FFR) is now well established for the purpose of guiding multi-vessel revascularization. Chronic total coronary occlusions are frequently associated with multi-vessel disease and the collateral dependent myocardium distal to the occlusion is often supplied by a collateral supply from another epicardial coronary artery. The haemodynamic effect of collateral donation upon collateral donor vessel flow may have important implications for the vessel's FFR; rendering it unreliable at predicting ischaemia should the CTO be revascularized. As a consequence, in the setting of multi-vessel disease, optimal revascularization strategy might be altered. There is a paucity of work in the medical literature directly examining this phenomenon. We endeavoured to review the existing literature related to it, to summarise from current knowledge of coronary physiology what is known about the potential effects of CTO revascularization on both collateral flow and collateral donor vessel physiology, and to highlight where further studies might inform practice. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free