title: Fate of collateral vessels following subintimal angioplasty.
abstract: OBJECTIVE
  To evaluate the fate of collateral vessels adjacent to and within the target lesion following subintimal angioplasty (SIA).
  
  
  METHODS
  Pre and postprocedural angiograms were reviewed for 29 patients undergoing SIA of the lower extremity arteries over a 3-year period. The number of patent collateral vessels </=5 cm proximal to the occlusion (proximal segment) and </=5 cm distal to the occlusion (distal segment) were recorded pre and postprocedurally and compared. In addition, the number of collateral vessels that were re-opened within the recanalized segment following SIA was counted.
  
  
  RESULTS
  The mean number of patent collaterals in the proximal segment was 1.9 (range 0-4) preprocedurally and 1.4 (range 0-4) postprocedurally (p<0.002). The mean number of patent collaterals in the distal segment was 1.9 (range 0-4) pre-procedurally and 1.0 (range 0-4) postprocedurally (p<0.0001). Previously absent collaterals within the recanalized segment were observed in 4 (14%) of 29 patients post-SIA. The mean number of collateral vessels within all 3 segments (proximal, treated, and distal) was 3.9 collaterals preprocedurally and 2.9 collaterals postprocedurally.
  
  
  CONCLUSIONS
  Some collateral vessels are sacrificed during SIA, but the majority are preserved. In addition, SIA has the potential to open new collaterals within the occluded segment. These collaterals may play an important role should restenosis develop within the target segment.
authors.affiliation: Department of Surgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York, USA. Elipsitz@aol.com
authors.forename: Evan C
authors.initials: EC
authors.lastname: Lipsitz
authors.forename: Takao
authors.initials: T
authors.lastname: Ohki
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Veith
authors.forename: Soo J
authors.initials: SJ
authors.lastname: Rhee
authors.forename: Harrie
authors.initials: H
authors.lastname: Kurvers
authors.forename: Carlos
authors.initials: C
authors.lastname: Timaran
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Gargiulo
authors.forename: William D
authors.initials: WD
authors.lastname: Suggs
authors.forename: Reese A
authors.initials: RA
authors.lastname: Wain
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D003097:Collateral Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000628:therapy; D007511:Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging; D014654:Vascular Patency / Q000502:physiology