Collateral circulation grading
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2]
Overview
Angiographic assessment of apparent collaterals is useful to quantify the angiogenic response to interventions designed to enhance myocardial perfusion and function in ischemic myocardium.[1] [2] [3]. Collateral Circulation is assessed visually using the following grading system:
- Grade 0: No collaterals present. Angiography fails to reveal evidence of collateral vessels.
- Grade 1 (or partial): Minimal collaterals present. Evidence of minimal to partial filling of the recipient branch epicardial arteries/infarct region. It is not necessary for one to see the branches connect directly to the major epicardial artery.
- Grade 2 (or complete): Well-developed collaterals. Evidence of collateral circulation with near complete to complete filling of the recipient major epicardial artery/infarct region.
- Grade 3 (myocardial): Filling of the myocardium by collaterals. If the collaterals are not filling any visible arterial branch, but are only participating in the perfusion of the myocardium.
Examples
References
- ↑ Fuchs S. Lack of correlation between angiographic grading of collateral and myocardial perfusion and function. Coron Ar Disease 2001; 12: 173-78.
- ↑ Abbott JD, Choi EJ, Selzer F, Srinivas VS, Williams DO Impact of Coronary Collaterals on Outcome Following PCI [from the NHLBI Dynamic Registry]. Am J Cardiol. 2005; 96: 676–680.
- ↑ Koerselman J, van der Graaf Y, de Jaegere PP, Grobbee DE. Coronary Collaterals an Important and Underexposed Aspect of Coronary Artery Disease. Circulation. 2003; 107: 2507-2511.