Document Detail

Does a well developed collateral circulation predispose to restenosis after percutaneous coronary intervention? An intravascular ultrasound study.
MedLine Citation:
PMID:  16216859     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate whether a well developed collateral circulation predisposes to restenosis after percutaneous coronary intervention (PCI).
DESIGN: Prospective observational study.
PATIENTS AND SETTING: 58 patients undergoing elective single vessel PCI in a tertiary referral interventional cardiac unit in the UK.
METHODS: Collateral flow index (CFI) was calculated as (Pw-Pv)/(Pa-Pv), where Pa, Pw, and Pv are aortic, coronary wedge, and right atrial pressures during maximum hyperaemia. Collateral supply was considered poor (CFI < 0.25) or good (CFI > or = 0.25).
MAIN OUTCOME MEASURES: In-stent restenosis six months after PCI, classified as neointimal volume > or = 25% stent volume on intravascular ultrasound (IVUS), or minimum lumen area < or = 50% stent area on IVUS, or minimum lumen diameter < or = 50% reference vessel diameter on quantitative coronary angiography.
RESULTS: Patients with good collaterals had more severe coronary stenoses at baseline (90 (11)% v 75 (16)%, p < 0.001). Restenosis rates were similar in poor and good collateral groups (35% v 43%, p = 0.76 for diameter restenosis, 27% v 45%, p = 0.34 for area restenosis, and 23% v 24%, p = 0.84 for volumetric restenosis). CFI was not correlated with diameter, area, or volumetric restenosis (r2 < 0.1 for each). By multivariate analysis, stent diameter, stent length, > 10% residual stenosis, and smoking history were predictive of restenosis.
CONCLUSION: A well developed collateral circulation does not predict an increased risk of restenosis after PCI.
D Perera; P Postema; R Rashid; S Patel; L Blows; M Marber; S Redwood
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-10-10
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  92     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-15     Completed Date:  2006-06-19     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  763-7     Citation Subset:  AIM; IM    
Department of Cardiology, Rayne Institute, St Thomas' Hospital Campus, King's College London, UK.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Case-Control Studies
Collateral Circulation / physiology*
Coronary Angiography
Coronary Restenosis / etiology*,  physiopathology,  ultrasonography
Coronary Stenosis / physiopathology,  therapy*,  ultrasonography
Middle Aged
Predictive Value of Tests
Prospective Studies
Risk Factors

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