Physiologic significance of coronary collaterals in chronic total occlusions

Minh N. Vo, Emmanouil S. Brilakis, Malek Kass, Amir Ravandi

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Chronic total occlusions (CTOs) are commonly found in patients with coronary artery disease, and a system of collateral connections are found in almost all of these patients. These collateral vessels serve to prevent myocardial necrosis but are not sufficient to prevent myocardial ischemia during exercise. Unfortunately, the presence of well-developed collaterals has been used as argument against CTO revascularization. Many continue to falsely believe that these patients are “protected” by collaterals and, therefore, CTO recanalization is not indicated. Our knowledge of the physiologic significance of coronary collaterals has increased significantly over the past several years. Studies utilizing coronary pressure and flow velocity have answered a number of basic physiologic questions. We therefore sought to review the evidence for coronary collateral flow and their clinical significance in patients with CTOs.

Original languageEnglish (US)
Pages (from-to)867-871
Number of pages5
JournalCanadian Journal of Physiology and Pharmacology
Issue number10
StatePublished - Jan 19 2015


  • Angioplasty
  • Chronic total occlusions
  • Coronary artery disease
  • Percutaneous coronary interventions

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Pharmacology


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