Effects of Retrograde Filling on Antegrade Flow of Coronary Artery with Significant (High Grade) Stenosis

Objectives- The aim of this study was to evaluate effects of retrograde filling on the patency of significant (high-grade, >90%) coronary arterial stenosis. Methods- The basis of our study was a comparison between the first and the second angiography of 102 patients with at least a 3-month interval between the two angiographies. Seventy-four of the patients were male (72.5%) and twenty-eight were female (27.4%). The patients were between the ages of 40 and 75, and the mean patient age was 61. Patients were not classified in order of risk factors, and none of them had diabetes mellitus. All 102 patients were classified in two groups (A and B) in regard to the presence or absence of retrograde filling. Group A (34 patients) consisted of patients with retrograde flow of grade 3 (complete perfusion) or 2 (partial collateral flow), whereas patients with retrograde filling grade 1(barely detectable collateral flow) or 0 (no collateral flow) were put into group B (68 patients). Results- In the second angiography, total occlusion occurred in the target vessels of 30 patients (88.24%) in group A and 12 patients (17.65%) in group B. Ninety percent occlusion and existence of antegrade flow was seen in 4 (11.76%) and 56 (82.35%) patients of group A and B, respectively. Results were analyzed through a Chi-square test. Total occlusion occurred in the patients with retrograde collateral flow significantly more than in patients without retrograde collateral vessels. (P=0.001). Conclusion- As the severity of obstruction leads to retrograde collateral development, significant retrograde collaterals cause earlier total vessel occlusion (Iranian Heart Journal 2007; 8 (2): 30-34).