Angiographic characteristics and clinical relations of coronary
collaterals in chronic total occlusion lesions

    Authors

    Keywords

    chronic total occlusion, collateral, Werner, Rentrop

    DOI

    https://doi.org/10.15836/ccar2018.48

    Full Text

    **Introduction**: Coronary collaterals (CC) are anastomotic connections that can provide an alternative blood supply. They are especially important in the case of the vessel occlusion as they are prerequisite of viability. Collaterals have an indispensable role in any type of chronic total occlusion (CTO) intervention. (1) Aim of our study was to analyze angiographic characteristics and clinical relations of collaterals in CTO patients. **Patients and Methods**: Consecutive patients, in whom at least one attempt of CTO intervention in our institution was attempted, were enrolled. Data from 133 patients were collected from the beginning of the 2015 to the June of 2017. Angiographic characteristics were analyzed using Rentrop and Werner classifications. Possible relation of those angiographic characteristics to coronary risk factors were sought. Association of CC angiographic characteristics and individual components of the so called optimal medical therapy (OMT) was also investigated. 79 (59.4%) had a CTO of right coronary artery (RCA), 36 (27.1%) of left anterior descending (LAD) and 18 (13.5%) of circumflex artery. Mean age was 63.6±9.2 years. Mean Rentrop score was 2.1±0.84 and mean Werner score was 1.37±0.51. 99 patients (74.4%) had heterocollaterals. Collaterals were frequently (58 patients - 44%) of multiple locations i.e. both septal and bridging. Further analyses showed no relation between angiographic characteristics of CC and coronary disease risk factors. No association of any individual component of OMT and CC angiographic characteristics was found. There was a trend of higher Werner class in men as opposed to women (1.42±0.53 vs 1.25±0.43; p=0.07). **Conclusion**: Our results show that most of the patients have heterocollaterals and frequently from different localizations. We found no connection between angiographic characteristics of CC and coronary disease risk factors as well as medical therapy.

    Literature

    1. Meier P, Schirmer SH, Lansky AJ, Timmis A, Pitt B, Seiler C. The collateral circulation of the heart. BMC Med. 2013 Jun 4;11:143. https://doi.org/10.1186/1741-7015-11-143
    Cardiologia Croatica
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    Angiographic characteristics and clinical relations of coronary
collaterals in chronic total occlusion lesions

    Extended Abstract
    Issue1-2
    Published
    Pages48
    PDF via DOIhttps://doi.org/10.15836/ccar2018.48
    chronic total occlusion
    collateral
    Werner
    Rentrop

    Authors

    Tomislav Letilović*University Hospital “Merkur”, Zagreb, Croatia
    Damir KozmarUniversity Hospital “Merkur”, Zagreb, Croatia
    Darko PočanićUniversity Hospital “Merkur”, Zagreb, Croatia
    Mario StipinovićUniversity Hospital “Merkur”, Zagreb, Croatia
    Maro DragičevićUniversity Hospital “Merkur”, Zagreb, Croatia
    Vedran RadonićUniversity Hospital “Merkur”, Zagreb, Croatia
    Helena JerkićUniversity Hospital “Merkur”, Zagreb, Croatia

    *Correspondence email: tomislavletilovic@gmail.com

    Full Text

    Introduction: Coronary collaterals (CC) are anastomotic connections that can provide an alternative blood supply. They are especially important in the case of the vessel occlusion as they are prerequisite of viability. Collaterals have an indispensable role in any type of chronic total occlusion (CTO) intervention. (1) Aim of our study was to analyze angiographic characteristics and clinical relations of collaterals in CTO patients.

    Patients and Methods: Consecutive patients, in whom at least one attempt of CTO intervention in our institution was attempted, were enrolled. Data from 133 patients were collected from the beginning of the 2015 to the June of 2017. Angiographic characteristics were analyzed using Rentrop and Werner classifications. Possible relation of those angiographic characteristics to coronary risk factors were sought. Association of CC angiographic characteristics and individual components of the so called optimal medical therapy (OMT) was also investigated. 79 (59.4%) had a CTO of right coronary artery (RCA), 36 (27.1%) of left anterior descending (LAD) and 18 (13.5%) of circumflex artery. Mean age was 63.6±9.2 years. Mean Rentrop score was 2.1±0.84 and mean Werner score was 1.37±0.51. 99 patients (74.4%) had heterocollaterals. Collaterals were frequently (58 patients - 44%) of multiple locations i.e. both septal and bridging. Further analyses showed no relation between angiographic characteristics of CC and coronary disease risk factors. No association of any individual component of OMT and CC angiographic characteristics was found. There was a trend of higher Werner class in men as opposed to women (1.42±0.53 vs 1.25±0.43; p=0.07).

    Conclusion: Our results show that most of the patients have heterocollaterals and frequently from different localizations. We found no connection between angiographic characteristics of CC and coronary disease risk factors as well as medical therapy.

    Literature

    1. 1.
      Meier P, Schirmer SH, Lansky AJ, Timmis A, Pitt B, Seiler C. The collateral circulation of the heart. BMC Med. 2013 Jun 4;11:143.DOI