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Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 169-171

Coronary collateral connection score in chronic total coronary occlusion lesions in the view of ELShafey speculation

1 Cardiology Department of EL Menoufia University Hospital, Shebien EL Koom, Menoufia, Egypt
2 Department of Medicine, Catania University, Sicily, Italy

Correspondence Address:
Dr. Wassam ELDin H ELShafey
Cardiology Department, EL Menoufia University Hospital, Shebien EL Koom, Menoufia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IHJI.IHJI_22_18

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Human coronary collaterals are intercoronary communications that are believed to be present from birth. In the presence of chronic total coronary occlusions (CTO), a total occlusion of perceived or known duration of 3 months or longer is labeled as chronic occlusion. Recruitment of flow via these collateral anastomoses to the arterial segment distal to occlusion provides an alternative source of blood flow to the myocardial segment at risk. Although coronary angiography is the standard method to visualize collateral arteries, it has a limited resolution. The visible collaterals have a diameter from 0.3 up to 0.5mm, therefore arterioles <100 µm are unseen by the human eye. In addition, nitrates and adenosine allow a better visualization of collateral branches, exploiting their vasomotor properties. A reported quantitative angiographic analysis of collateral diameters on high-resolution cine films underscored the relevance of the collateral diameter for the collateral function. Aside from the complexity of this approach, its applicability to modern digital storage standards with lower resolutions is limited. ELShafey speculation is based on using a modified pattern of the inverted gray scale of cine angiograms for a better visualization of different ambiguity coronary artery lesions.

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