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Vieussens' ring coronary collateral circulation: a natural bypass history

Cesare Mantini1, Valeria Di Mascio2, Domenico Mastrodicasa3

  • 1Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy. cesare.mantini@gmail.com.

Acta Bio-Medica : Atenei Parmensis
|April 5, 2022
PubMed

Insights

Vieussens' ring, a coronary collateral pathway, can supply blood to the left anterior descending artery during stenosis. Coronary CT angiography effectively visualizes this natural bypass and its anatomy.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Vieussens' ring is a critical hetero-coronaric pathway connecting the right coronary artery and left anterior descending artery.
  • This collateral circulation is vital when significant stenosis affects either major coronary artery.

Observation:

  • A 62-year-old male presented with chest pain and was found to have a mid-left anterior descending artery occlusion.
  • Coronary angiography revealed delayed distal opacification via Vieussens' ring, indicating collateral flow.

Findings:

  • Coronary computed tomography angiography (CCTA) confirmed the presence and detailed anatomical course of Vieussens' ring.
  • CCTA demonstrated the collateral vessel's relationship with adjacent cardiac structures.

Implications:

  • Coronary computed tomography angiography is a valuable tool for assessing hetero-coronaric collateral vessels.
  • High-resolution CCTA provides comprehensive anatomical detail of coronary collaterals, aiding in clinical evaluation.

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