Relation between collateral flow assessed by Doppler guide wire and angiographic collateral grades

• Published in: The American heart journal Vol. 130; no. 1; pp. 32 - 37
• Main Authors: Yamada, Tadakatsu, Okamoto, Mitsunori, Sueda, Takashi, Hashimoto, Masaki, Kajiyama, Goro
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.1995; Elsevier
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Angina Pectoris - diagnosis; Angina Pectoris - physiopathology; Angina Pectoris - therapy; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Balloon, Coronary - methods; Biological and medical sciences; Blood Flow Velocity; Cardiac Catheterization; Cardiovascular system; Chi-Square Distribution; Collateral Circulation; Coronary Angiography - instrumentation; Coronary Angiography - methods; Coronary Angiography - statistics & numerical data; Coronary Circulation; Coronary Vessels - diagnostic imaging; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Statistics, Nonparametric; Ultrasonic investigative techniques; Ultrasonography, Doppler - instrumentation; Ultrasonography, Doppler - methods; Ultrasonography, Interventional - instrumentation; Ultrasonography, Interventional - methods; Ultrasonography, Interventional - statistics & numerical data; Sonography; Doppler ultrasound study; Human; Collateral circulation; Echocardiography; Radiodiagnosis; Angiography; Coronary artery; Cardiovascular disease; Exploration; Coronary heart disease; Comparative study
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/0002-8703(95)90232-5

We investigated the relation between the angiographic collateral grade (Rentrop's classification) and the collateral flow velocity pattern in 43 patients with angina pectoris. Collateral flow velocity was measured with a Doppler guide wire during balloon occlusion in coronary angioplasty. Collateral flow was detected in 21 of the 43 patients. In 6 of the 21 patients, collateral vessels were not seen angiographically before angioplasty. The direction of collateral flow was classified as forward, backward, or bidirectional. Forward and backward collateral flows were seen in all angiographic grades. Bidirectional collateral flows were observed only in grades 0 to 2. The peak collateral flow velocity was not correlated with the angiographic grades, but the ratio of the collateral flow duration to a cardiac cycle length was correlated with them (grade 0, 44% ± 15%; grade 1, 70% ± 16%; grade 2, 84% ± 11%; and grade 3, 93% ± 3%; p < 0.0005, analysis of variance). The peak velocity integral was also correlated with the angiographic collateral grades ( p < 0.05; analysis of variance). Electrocardiographic signs of ischemia were less observed in patients with unidirection and longer duration of collateral flow pattern ( p < 0.05, respectively). A Doppler guide wire may be useful in assessing collateral flow grade.