Bidirectional function of coronary collateral channels in humans.

To investigate the bidirectional functional adequacy of collateral perfusion, we performed percutaneous transluminal coronary angioplasty (PTCA) on highly stenosed or occluded coronary arteries visualized by the collateral circulation,which were fed by the contralateral coronary artery with severe stenosis. After successful PTCA in all three patients, the contralateral artery was reversely filled by good collateral circulation originating from the dilated coronary artery. These findings indicated that dilation of the receiving coronary artery reversed the pressure gradient across the collateral network, establishing collateral flow in the opposite direction. It was concluded that human collateral channels serve as a bidirectionally functional conduit.