Related Experiment Video

Updated: Jul 15, 2026

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

Recruitable collateral blood flow index predicts coronary instent restenosis after percutaneous coronary intervention

Lisette Okkels Jensen1, Per Thayssen, Jens Flensted Lassen

  • 1Department of Cardiology, Catheterization Laboratory, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. okkels@dadlnet.dk

European Heart Journal
|April 26, 2007
PubMed

Insights

Recruitable collateral blood flow measured during percutaneous coronary intervention (PCI) predicts in-stent restenosis in patients receiving bare metal stents. Higher collateral flow index (CFI) indicates better collateral blood flow and is linked to increased restenosis rates.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Collateral circulation plays a crucial role in myocardial perfusion, potentially influencing outcomes after percutaneous coronary intervention (PCI).
  • Hemodynamic forces from collateral flow can compete with antegrade flow post-PCI, impacting long-term results.
  • Understanding the influence of recruitable collateral blood flow is essential for optimizing PCI strategies, especially with bare metal stents.

Purpose of the Study:

  • To assess the impact of recruitable collateral blood flow on restenosis rates in patients undergoing PCI with bare metal stents.
  • To determine if collateral blood flow, measured by the collateral flow index (CFI), can predict angiographic restenosis.
  • To evaluate the relationship between pre-interventional fractional flow reserve (FFR) and collateral flow.

Main Methods:

  • Ninety-five patients with de novo coronary lesions treated with PCI and bare metal stents were studied.
  • Fractional flow reserve (FFR) was measured at maximum hyperemia induced by intravenous adenosine.
  • Collateral flow index (CFI) was derived from coronary wedge pressure and central venous pressure during transient coronary occlusion via balloon inflation.

Main Results:

  • Pre-interventional FFR correlated inversely with CFI (r = -0.356, P < 0.001).
  • Patients with well-developed collaterals (CFI ≥ 0.25) exhibited a lower pre-interventional FFR and a significantly higher rate of binary restenosis (54.2% vs. 19.4%, P = 0.003) compared to those with poorly developed collaterals (CFI < 0.25).
  • CFI (multiplied by 100) was identified as an independent predictor of restenosis at 9 months (OR 1.07, P = 0.016).

Conclusions:

  • Recruitable collateral blood flow, quantified by CFI during balloon inflation, is a significant predictor of angiographic in-stent restenosis after PCI in patients treated with bare metal stents.
  • The findings suggest that robust collateral circulation may paradoxically be associated with a higher risk of restenosis in this patient group.
  • This highlights the importance of assessing collateral flow in predicting PCI outcomes.
Abstract

Related Concept Videos

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...