title: The collateral circulation of the heart.
abstract: The coronary arteries have been regarded as end arteries for decades. However, there are functionally relevant anastomotic vessels, known as collateral arteries, which interconnect epicardial coronary arteries. These vessels provide an alternative source of blood supply to the myocardium in cases of occlusive coronary artery disease. The relevance of these collateral arteries is a matter of ongoing debate, but increasing evidence indicates a relevant protective role in patients with coronary artery disease. The collateral circulation can be assessed by different methods; the gold standard involves intracoronary pressure measurements. While the first clinical trials to therapeutically induce growth of collateral arteries have been unavailing, recent pilot studies using external counterpulsation or growth factors such as granulocyte colony stimulating factor (G-CSF) have shown promising results.
authors.affiliation: The Heart Hospital London, University College London Hospitals UCLH, London, UK. pascalmeier74@gmail.com
authors.forename: Pascal
authors.initials: P
authors.lastname: Meier
authors.forename: Stephan H
authors.initials: SH
authors.lastname: Schirmer
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Adam
authors.initials: A
authors.lastname: Timmis
authors.forename: Bertram
authors.initials: B
authors.lastname: Pitt
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D003097:Collateral Circulation / Q000502:physiology*; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000502:physiology*; D006321:Heart / Q000502:physiology; D006801:Humans