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Cardiovascular Research 2000 47(2):359-366; doi:10.1016/S0008-6363(00)00109-7
© 2000 by European Society of Cardiology
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Copyright © 2000, European Society of Cardiology

Measurement of coronary collateral flow and resistance in the presence of an open critical stenosis, and the response to intra-arterial thrombosis

M Mansaraya, J.W Hynda, I Vergroesenb, P.R Belcherc, A.J Drake-Hollanda and M.I.M Noblea,*

aDepartment of Cardiovascular Medicine, Room 5L16, Imperial College School of Medicine, National Heart and Lung Institute, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
bDepartment of Medical Physics, Academic Medical Centre, Amsterdam, The Netherlands
cDepartment of Cardiothoracic Surgery, University of Glasgow, Royal Infirmary, Glasgow, UK

* Corresponding author. Tel.: +44-181-846-1025; fax: +44-181-846-7678 m.noble{at}ic.ac.uk

Objective: (1) Can one measure coronary collateral flow around an open critical stenosis? (2) Does intracoronary platelet thrombosis affect native coronary collateral vessels? Methods: We measured regional myocardial blood flow by the radioactive microsphere technique in seven anaesthetised dogs with an ultrasonic flowmeter on the circumflex branch of the left coronary artery (LCx). Measurements were made (a) in a control period, (b) after induction of a tight stenosis on the LCx, and (c) after additional arterial damage at the stenosis to induce intraluminal thrombosis. Collateral flow was calculated from LCx tissue flow(in ml/min/g tissue) minus LCx flowmeter flow which is in ml/min. Therefore, it was necessary to use scaling by reference back to the control measurements and conversion to ml/min/g tissue equivalent. Results: LCx stenosis induced collateral flow from the other coronary arteries into the LCx area of supply, which decreased (mean±S.E.) from 0.23±0.03 to 0.15±0.05 ml/min/g tissue with thrombosis. Collateral resistance correspondingly increased with thrombosis from 187.6±18.2 to 1069±544 mmHg/ml/min/g (P<0.02). Conclusion: Coronary collateral flow around an open stenosis can be measured by reference back to control conditions. The coronary collaterals vasoconstrict in the presence of thrombosis even though they are in the stream of blood coming from normal coronary arteries.

KEYWORDS Blood flow; Collateral circulation; Coronary circulation; Ischemia; Platelets; Thrombosis/embolism; Vasoconstriction/dilation


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