Coronary artery tortuosity: Difference between revisions

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==Definition==
==Definition==
Although coronary artery tortuosity still has unclear fixed definition, this phenomenon described as a two following 180°turns of a major epicardial artery.<ref name="pmid19585899">{{cite journal| author=Groves SS, Jain AC, Warden BE, Gharib W, Beto RJ| title=Severe coronary tortuosity and the relationship to significant coronary artery disease. | journal=W V Med J | year= 2009 | volume= 105 | issue= 4 | pages= 14-7 | pmid=19585899 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19585899  }} </ref>  Other definition of CT is described by another authors as a fixed ≥3 bends during both systole and diastole, in at least a single epicardial artery, with each bend ≥45° change in the vessel direction.<ref name="pmid17216126">{{cite journal| author=Turgut O, Yilmaz A, Yalta K, Yilmaz BM, Ozyol A, Kendirlioglu O et al.| title=Tortuosity of coronary arteries: an indicator for impaired left ventricular relaxation? | journal=Int J Cardiovasc Imaging | year= 2007 | volume= 23 | issue= 6 | pages= 671-7 | pmid=17216126 | doi=10.1007/s10554-006-9186-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17216126  }} </ref>
Although coronary artery tortuosity still has unclear fixed definition, this phenomenon described as a two following 180°turns of a major epicardial artery.<ref name="pmid19585899">{{cite journal| author=Groves SS, Jain AC, Warden BE, Gharib W, Beto RJ| title=Severe coronary tortuosity and the relationship to significant coronary artery disease. | journal=W V Med J | year= 2009 | volume= 105 | issue= 4 | pages= 14-7 | pmid=19585899 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19585899  }} </ref>  Another definition of CT is described by different authors as a fixed ≥3 bends during both systole and diastole, in at least a single epicardial artery, with each bend ≥45° change in the vessel direction.<ref name="pmid17216126">{{cite journal| author=Turgut O, Yilmaz A, Yalta K, Yilmaz BM, Ozyol A, Kendirlioglu O et al.| title=Tortuosity of coronary arteries: an indicator for impaired left ventricular relaxation? | journal=Int J Cardiovasc Imaging | year= 2007 | volume= 23 | issue= 6 | pages= 671-7 | pmid=17216126 | doi=10.1007/s10554-006-9186-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17216126  }} </ref>


==Pathophysiology==
==Pathophysiology==

Revision as of 18:49, 16 December 2013

Coronary Angiography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vanessa Cherniauskas, M.D. [2], Mohamed Moubarak, M.D. [3]

Synonyms and keywords: Serpentine coronary artery

Overview

Coronary tortuosity (CT) is a common finding in coronary angiography settings. Although the unclear clinical importance of this phenomenon, the importance of CT comes from the possibility of reducing the coronary blood supply, through the reduced coronary perfusion pressure distal to the tortuous point of the coronary artery, as a result to this kinking and tortuosity, which may lead to ischemia.[1]

Definition

Although coronary artery tortuosity still has unclear fixed definition, this phenomenon described as a two following 180°turns of a major epicardial artery.[2] Another definition of CT is described by different authors as a fixed ≥3 bends during both systole and diastole, in at least a single epicardial artery, with each bend ≥45° change in the vessel direction.[3]

Pathophysiology

Coronary artery tortuosity pathophysiology is still unclear, and it is believed to be a result of an arterial remodeling due to elastin degeneration in the arterial wall.[4] Elastin degeneration may occur with age, atherosclerosis, hypertension, aneurysms, ectasias, and diabetes mellitus.[5]

Epidemiology and Demographics

Diagnosis

Coronary Angiography

Clinical Significance

Treatment

Example

References

  1. Zegers ES, Meursing BT, Zegers EB, Oude Ophuis AJ (2007). "Coronary tortuosity: a long and winding road". Neth Heart J. 15 (5): 191–5. PMC 1877966. PMID 17612682.
  2. Groves SS, Jain AC, Warden BE, Gharib W, Beto RJ (2009). "Severe coronary tortuosity and the relationship to significant coronary artery disease". W V Med J. 105 (4): 14–7. PMID 19585899.
  3. Turgut O, Yilmaz A, Yalta K, Yilmaz BM, Ozyol A, Kendirlioglu O; et al. (2007). "Tortuosity of coronary arteries: an indicator for impaired left ventricular relaxation?". Int J Cardiovasc Imaging. 23 (6): 671–7. doi:10.1007/s10554-006-9186-4. PMID 17216126.
  4. Panduranga P, Riyami AA (2011). "Serpentine coronary arteries: in a patient with apical hypertrophic cardiomyopathy". Tex Heart Inst J. 38 (5): 594–5. PMC 3231533. PMID 22163145.
  5. Xie X, Wang Y, Zhu H, Zhou H, Zhou J (2013). "Impact of coronary tortuosity on coronary blood supply: a patient-specific study". PLoS One. 8 (5): e64564. doi:10.1371/journal.pone.0064564. PMC 3656900. PMID 23691249.


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