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在过去的几十年里,冠状动脉已被视为末端动脉。然而,在心外膜冠状动脉上有功能上相关的吻合血管,称为侧支动脉。这些血管为闭塞性冠状动脉疾病提供了另一条心肌血液供应的来源。与这些侧支动脉的有关问题仍存在争论,但越来越多的证据表明其对冠状动脉疾病的患者具有保护作用。侧支循环可以通过不同的方法进行评估,金标准是冠脉内压力测量。但是第一个以治疗诱导侧支血管生长的临床实验一直徒劳,最近的实验研究采用体外反搏或生长因子,如粒细胞集落刺激因子(G-CSF)已显示可能有结果。
In the past few decades, the coronary arteries have been considered distal arteries. However, there is a functionally relevant anastomotic vessel on the epicardial coronary artery called the collateral artery. These blood vessels provide another source of myocardial blood supply for occlusive coronary artery disease. There are still controversies with these collateral arteries, but there is growing evidence that they have a protective effect on patients with coronary artery disease. Collateral circulation can be assessed by different methods, the gold standard is intracoronary pressure measurement. However, the first clinical trial to induce collateral vessel growth has been futile, with recent studies using extracorporeal counterpulsation or growth factors such as granulocyte-colony stimulating factor (G-CSF) that have shown promise.