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Stents and Collaterals
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Stents and Collaterals

Do stents interfere with collateral growth of arteries?  Also, would EECP help create collateral growth and is EECP therapy contraindicated in stent patients for any reason?

Lastly, I have a question that has always twisted my head around in knots trying to think about it.  My LAD is stented from proximal to apex.  I know there are diaganal arteries that come off the LAD - some long and some short.  Would not a stent in these areas (especially after the scarring begain) basically shut off blood supply to these arteries?
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Stents, if patent, are likely to decrease collateral flow to the arteries in which they are in, thye will not affect distant arteries.  This is not a problme because forward flow (throught the stent) and collateral flow are both driven by a pressure difference, so as long as there is forward flow, the collateral flow is no longer necessary.  Again, stents do not inhibit collateral flow to the unstented arteries.  EECP is done to alleviate chest pain from disease in arteries that are still diseased (unstented), therefore it is not contraindicated.  Finally, stents have struts in them so they do not cover the openings of the diagonals, thereby, permitting continuous flow to those segements.  
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