Disease relevance of Collateral Circulation

• Among 68 patients with significant coronary stenoses, those who received nitroglycerin and had coronary collateral circulation were more likely to exhibit improved reversibility after reinjection than the remaining patients (50% versus 21%, P < .05) [1].
• Distal coronary pressure was markedly reduced during balloon coronary occlusion (14 +/- 7 mm Hg, p < 0.05 vs. both adenosine and ischemia), suggesting the absence of significant collateral circulation [2].
• Thus in conscious dogs with regressed newly developed collaterals a major component of the beneficial effects of glyceryl trinitrate on collateral circulation is dilatation of collateral vessels, as evidenced by a pronounced increase in collateral blood flow and myocardial function during a transient period of coronary occlusion [3].
• Improvement of collateral circulation after arterial thrombosis with indomethacin therapy [4].
• VEGF-induced angiogenesis drives collateral circulation in portal hypertension [5].

High impact information on Collateral Circulation

• L-NMMA did not alter the portal pressure or portosystemic shunting in these cirrhotic rats, yet portal vascular resistance increased, suggesting effects on the intrahepatic and collateral circulation [6].
• Thus, we investigated whether MOR-14 could inhibit alpha-1,6-glucosidase and reduce the infarct size in rabbit hearts without collateral circulation [7].
• CONCLUSIONS: Nitrate-augmented 201Tl reinjection significantly, albeit modestly, improves detection of defect reversibility, especially in patients with coronary collateral circulation [1].
• Collateral circulation was detected in 23 of 29 (79%) regions with a positive thallium reinjection effect but in only 1 of the other 7 regions (P < .01) [8].
• Vasopressin and the mature coronary collateral circulation [9].

Chemical compound and disease context of Collateral Circulation

• To determine acute postischemic metabolic changes of the ischemic rim under conditions of poor collateral circulation, we examined cerebral blood flow and glucose metabolism in the area of the brain around the ischemic tissue in 36 male spontaneously hypertensive stroke-prone rats (SHRSP) in the acute stage of focal ischemia [10].
• It is concluded that superior portosystemic collateral blood flow is elevated in patients with cirrhosis and that the reduction in this collateral circulation might explain the efficiency of propranolol in the prevention of recurrent gastrointestinal bleeding [11].
• Acetazolamide SPECT scans demonstrate a decreased perfusion reserve in 20 patients with carotid artery stenosis, indicating reduced perfusion and poor collateral circulation [12].
• Thus the collateral circulation, promoted by repetitive anginal episodes indicative of myocardial ischemia, causes the preservation of myocardial function [13].
• Groups A and B were comparable in age, infarct vessel, collateral circulation, residual coronary stenosis and cumulative release of creatine kinase-MB isoenzyme [14].

Biological context of Collateral Circulation

• As a collateral circulation developed with consequent fall in portal venous pressure, PGI2-like activity decreased [15].
• Evidence indicates that after vascular occlusion, infusion of angiotensin II restores blood supply to ischemic tissues by stimulating the development of collateral circulation through a mechanism independent of the mechanical effects of increased blood pressure [16].
• Importance of coronary collateral circulation for kinetics of serum creatine kinase in acute myocardial infarction [17].
• Thus, the immature coronary collateral circulation was capable of active vasomotion, as demonstrated by vasodilation in response to nitroglycerin, but did not undergo vasoconstriction in response to alpha-adrenoceptor stimulation [18].

Anatomical context of Collateral Circulation

• Preferential dilation of recipient coronary arteries of the collateral circulation by intracoronary administration of nitroglycerin [19].
• This effect is observed with bFGF and VEGF in various animal models of endothelial dysfunction such as the collateral circulation, the regenerated endothelium following arterial injury and experimental atherosclerosis [20].
• Thallium-201 single photon emission tomography of myocardium: additional information in reinjection studies is dependent on collateral circulation [21].
• The twig appeared to be a network between the bifurcation of internal carotid artery and insular segment of MCA, and it was different from the collateral circulation due to acquired occlusion or moyamoya disease [22].
• Contrast inferior venacavograms revealed that one patient had persistent right and left supracardinal veins (double inferior vena cava) and the other had iliac vein occlusion with ascending lumbar collateral circulation [23].

Associations of Collateral Circulation with chemical compounds

• Improvement of treadmill capacity and collateral circulation as a result of exercise with heparin pretreatment in patients with effort angina [24].
• The attenuation of the response to vasopressin by NO and prostaglandin suggest a function role of both mediators in the regulation of the portal-systemic collateral circulation in portal hypertensive rats [25].
• This observation may explain the strong response of the collateral circulation to nitroglycerin in patients with functionally significant collateral channels [19].
• Nevertheless, in the ischemic heart without a significant collateral circulation, pretreatment with the calcium channel blocking drug, diltiazem, results in a delayed onset of cellular damage after acute coronary artery ligation and less cellular damage at ischemic periods up to 40 minutes' duration [26].
• Improvement of exercise capacity by sarpogrelate as a result of augmented collateral circulation in patients with effort angina [27].

Gene context of Collateral Circulation

• Monocyte chemoattractant protein-1 (MCP-1) stimulates the formation of a collateral circulation on arterial occlusion [28].
• CONCLUSIONS: The clinical significance of the celiac compression syndrome is evident in liver transplantation in which the collateral circulation to the liver is compromised and the celiac artery remains the only source of arterial blood [29].
• The exogenous application of TGF-beta1 led to an increase in both the number of visible collateral arteries as well as the conductance of the collateral circulation (4.0 +/- 0.5 ml/min/100 mmHg vs. 28.9 +/- 3.7 ml/min/100 mmHg, P<0.05) [30].
• Our results indicate that the leptomeningeal vessels of moyamoya disease are not newly formed but are merely dilated preexisting vessels and that the structural alteration of the vascular walls suggests their adaptability for participation in the collateral circulation at the cerebral surface [31].
• The results indicate that retroinfusion of superoxide dismutase into the great cardiac vein before reperfusion may be an effective treatment for the prevention of reperfusion injury, even in the absence of a well developed coronary collateral circulation [32].

Analytical, diagnostic and therapeutic context of Collateral Circulation

• The viability of myocardial tissue was assessed by exercise thallium-201 myocardial scintigraphy, and the collateral circulation was angiographically evaluated by means of a collateral index ranging from 0 to 3 [33].
• To clarify the inflow and outflow vessels of esophagogastric varices, we investigated the collateral circulation using endoscopic ultrasonography (EUS; Olympus GF-UM2, 7.5 MHz, radial type) during non-shunting operations in 16 cases of portal hypertension [34].
• Major collateral pathways in patients with celiac axis stenosis can be identified with spiral CT, and knowledge concerning this collateral circulation may be important for certain medical procedures such as interventional procedures for the management of hepatic tumors, pancreaticobiliary surgery, and liver transplantation [35].
• PURPOSE: The authors obtained noninvasive quantitative measurements of regional cerebral blood flow using Tc-99m L,L-ethyl cysteinate dimer (Tc-99m ECD) SPECT to evaluate cerebral collateral circulation during balloon test occlusion (BTO) of the internal carotid artery and vertebral artery (VA) [36].
• First of all, adenosine induces collateral circulation via induction of growth factors, and triggers ischemic preconditioning, both of which induce ischemic tolerance in advance [37].

References