The role of extracardiac vascularisation and intramyocardial collaterals in patients with coronary heart disease

Coronary heart disease plays a leading role in mortality from circulatory system diseases. In most cases, atherosclerotic process is underlying stenotic lesions of the coronary arteries. Current methods of CHD treatment, in particular, optimal medical therapy and surgical procedures (coronary bypass surgery and percutaneous coronary interventions), in some cases, are not able to ensure complete myocardial revascularisation. In this respect, a number of investigators are searching for new methods to solve this problem. One of the directions of the search is inducing of noncoronary collateral circulation development. This review discusses modern concepts of myocardial collateral blood supply, physiological aspects of the process of vascular network regeneration, contains data on intra- and extracardiac sources of blood flow, existing approaches to functional evaluation of certain collaterals, principles of stimulation of indirect myocardial revascularisation (based on the example of YurLeon technique).