Direct Quantitative Assessment of the Peripheral Artery Collateral Circulation in Patients Undergoing Angiography

• DOI: 10.1161/circulationaha.112.000516
• Publication Date: 2013-07-02T01:39:06Z
• Authors: Tobias Traupe; Jana Ortmann; Michael Stoller; Iris Baumgartner; Stefano F. de Marchi; Christian Seiler
• Keywords: Supine position; Collateral circulation; Posterior tibial artery

Background— Despite the fact that numerous studies have pursued strategy of improving collateral function in patients with peripheral artery disease, there is currently no method available to quantify arterial lower limb. Methods and Results— Pressure-derived flow index (CFIp, calculated as (occlusive pressure−central venous pressure)/(aortic pressure); pressure values mm Hg) left superficial femoral was obtained undergoing elective coronary angiography using a combined pressure/Doppler wire (n=30). Distal occlusive toe oxygen saturation (Sa o 2 ) were measured for 5 minutes under resting conditions, followed by an exercise protocol (repetitive plantar-flexion movements supine position; n=28). In all patients, balloon occlusion over painless conditions. CFIp increased during first 3 from 0.451±0.168 0.551±0.172 ( P =0.0003), whereas Sa decreased 98±2% 93±7% =0.004). Maximal changes inversely related maximal r =0.33, =0.003). During exercise, declined within 1 minute 0.560±0.178 0.393±0.168 <0.0001) reached its minimum after (0.347±0.176), 86±6% =0.002). Twenty-five (89%) experienced pain or cramps/tired muscles, (11%) remained symptom-free time 10 minutes. positively pain-free span =0.50, Conclusions— Quantitatively assessed at rest determined nonstenotic sufficient prevent ischemic symptoms total decline indicates supply-demand mismatch via collaterals or, alternatively, steal phenomenon. Clinical Trial Registration—URL: http://www.clinicaltrials.gov . Unique identifier: NCT01742455.