DAMAGE TO THE COLLATERAL CIRCULATION BY PTCA OF AN OCCLUDED CORONARY-ARTERY

In this report, a patient is described with an occluded left circumfle x artery, in whom the corresponding myocardium was protected at rest b y sufficient collateral circulation, Because of angina pectoris class III, a PTCA of that occluded vessel was performed, complicated by a la rge dissection, Recruitable collateral flow, assessed from pressure ca lculations by a new technique, suddenly decreased at the very moment o f dissection, This was accompanied by resting pain and ischemia on the EGG. This case report confirms the hypothesis that the collateral cir culation can be damaged by PTCA and emphasizes that every PTCA implies a definite risk, even in case of an occluded coronary artery filled b y collaterals. (C) 1995 Wiley-Liss, Inc.