Abstract

Clinical relevance of coronary collaterals in humans. The functional relevance of coronary collaterals in humans has yet to be fully explored. Several studies have demonstrated a protective role of collaterals in patients with coronary artery disease. On the other hand, negative aspects of well developed coronary collaterals have been reported, e.g., a higher rate of restenosis following coronary angioplasty, or a redistribution of blood via collaterals away from the myocardial area in need towards normally perfused areas (.coronary steal). In the past, the coronary collateral circulation has been assessed only qualitatively using visual angiographic or nuclear imaging methods. With the recent advent of intracoronary Doppler and pressure transducers, quantitative assessment of functional parameters of the coronary circulation has become feasible. This article reviews the methods used for the determination of coronary collateral circulation in humans as well as the clinically potentially beneficial aspects of well developed collaterals.

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