Collateral circulation involves small arteries that connect two larger coronary arteries or different segments of the same artery. They provide an alternate route for blood flow to the heart muscle. Everyone has collateral vessels, at least in microscopic form. These vessels aren't open under normal conditions but grow and enlarge in some people with coronary heart disease. When a collateral vessel enlarges, it lets blood flow from an open artery to either an adjacent artery or further downstream on the same artery. Myocardial ischemia stimulates collateral vessels, so they can form a kind of "detour" around a blockage, providing alternate routes of blood flow.
Research has shown that while everyone has collateral vessels, they don't open and become available in all people. Some people have available collaterals; others don't. People who have open collateral vessels are lucky, because collateral vessels help protect heart muscle from tissue death if the normal blood supply is cut off.
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