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  • Title: Enhancement of noncoronary collateral circulation: the hypothesis of an alternative treatment for ischemic heart disease.
    Author: Picichè M, Kingma JG, Fadel E, Dagenais F, Robillard J, Simard D, Voisine P.
    Journal: Med Hypotheses; 2010 Jan; 74(1):21-3. PubMed ID: 19747780.
    Abstract:
    The internal thoracic arteries (ITAs) are a source of "noncoronary collateral circulation" (NCCC), or "noncoronary collateral blood flow" (NCCBF). The hypothesis herein is that enhancement of NCCC may represent an alternative means of myocardial blood supply: (1) Ligature of the ITAs creates a local hypertensive status and increases the perfusion pressure within the channels leading to the heart; (2) Myocardial ischemic stimulus diverts most ITA-related collateral flow to the heart rather than to the chest wall; (3) The ITAs may develop neo-collaterals owing to their ischemia-related plastic potential; (4) Angiogenic growth factor administration within the ITAs enhances neo-collateral development. These elements may pave the way for a new field of cardiovascular research aimed at enhancing NCCC as a new therapeutic option for ischemic heart disease.
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