CORONARY COLLATERAL CIRCULATION IN LIVING MAN

The coronary arteriograms of 100 patients studied in our laboratory were reviewed and searched for the presence or absence of coronary collaterals. Fiftythree had either normal coronary arteriograms or less than 50 per cent lumen reduction. We found no collaterals in this group. The remaining 47 patients had more than 50 per cent lumen reduction of one or more of the main trunks or major branches. There was collateral circulation in 37 cases. Five had normal electrocardiograms. In 13, the existence of collaterals was inferred by visualization of an artery distal to a complete occlusion or from its opacification after injection of contrast agent into the heterolateral artery. In the remaining 24, continuity could be traced from the feeding artery through the collateral vessel into the recipient vessel. We describe several patterns of anastomotic pathways. The presence of coronary collaterals is a reliable indication of severe coronary artery disease and may account for a normal resting electrocardiogram even in patients with major arterial occlusion. © 1969.