- Coronary collateral circulation continues to be a poorly understood phenomenon.
- It reduces the impact of ischemia , salvage myocardium, keep it viable, and can even be life saving during a STEMI
- It can support either the same coronary artery or the contra lateral coronary artery (Like the above patient )
- The usefulness of collaterals at times of exertion is controversial .Most interventionists do not believe in it . (Facts are opposite of course !)
- Bridging coronary arterial collateral often indicate hardened total occlusion and success of PCI is reduced
Here is the angiogram which shows classical intra coronary bridging collaterals.