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Angiogenesis a bypass

My father has blocked arteries, but it appears there is adequate blood flow around a completely blocked left-side large vessel.of the heart.  I'm concerned and interested because this may happen to me so I have done some reading on the subject.  I read angiogenesis is the process and posts on this forum indicate the process is collateral vessel?  Thank you in advance.:)
48 Responses
367994 tn?1304957193
Yes, there is a difference.  Angiogenesis is the development of small vessels mostly small arterioles, capillaries and venules. It has a connection to generate small vessels from epithelium cells (lines the vessel), blood flow, etc.  Angiogenesis happens as an example from a wound.  Out of control, it can be cancerous tumor.

But when an exsisting artery is occluded  the development of blood flow from existing collaterals may be activated.  There is evidence, mechanisms leading to the development of collaterals capable of conducting blood efficieniently differs from those usually involved in angiogenesis.  I have read arteriogenesis is "state of art"  term that includes both angiogeneis and collateral growth recognizing the difference between the two processes.

If you have other questions...what has been stated is not very much detail, and I hope it is not confusing!
Avatar universal
Is there any physiological basis that can be relied on to develop collateral vessel bypass?  It seems some people or at least most people that have heart issues have stents or by-pass.  The short answer may be people that have a natural bypass don't participate on health forums as they don't have a heart a problem.  Are there autopsy reports or something?  I read autopsy reports state military personnel autopsies showed significant blockage in many young people!  No mention of any natural bypass.
976897 tn?1379171202
The development of collaterals doesn't occur in everyone. During one of my many stays in hospital, I was talking to a man who had a 95% occlusion in his LAD but no collaterals were forming. His Cariologist told him that the collaterals don't seem to always form in people and this is why it is still believed by some experts to have a genetic element. Collaterals are good if they form in that they can keep heart tissue alive. However, in many people they only provide enough Oxygen backup to be at rest or very slight exertion. So many people have the luxury of collaterals keeping them alive until a better solution can be decided.
I am still unsure what effect on collaterals a bypass or stent has. How does the increase in pressure in the LAD affect these newly formed vessels and the vessel providing them. Surely back pressure will be created. Collaterals in the bottom of my LAD were pushing blood UP the vessel and keeping me alive. However, now my LAD is fully patent, and high pressure is pushing DOWN the LAD, how is this affecting other vessels in my heart through the collaterals. I have an outpatients appointment with my cardiologist soon, I will ask him such questions and let everyone know. I also have a working Lima grafted to the LAD and this must also play around with pressure/flow as blood also streams in through the left main stem.
367994 tn?1304957193
Max, if I understand your question,  you are asking if there are any attributes or identifiable characteristics that are reliable to predict if one will have collaterals for their blocked vessels.
No, there is no way to know prior.  If your father has CAD, and collateral blood flow and you are concerned there may a genetic component for CAD, you need to take precautionary measures to prevent CAD such as control your cholesterol, blood pressure, proper diet, exercise, etc.

However, my notes on the subject  from a few years ago indicate there is evidence why some people with diabetes do not have adequate blood supplying collaterals.  There is a biological component associated with diabetes and the cardiovascular system.... and my notes indicate there is evidence supported by lab experiments and general knowledge of fluid dynamics (or hemodynamics) that more than one occlusion in the same vessel prevents an adequate flow of blood from collaterals....may require interventional therapy.
367994 tn?1304957193
This a Cleveland Clinic  doctor's response:  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.

>>>I agree with the doctor's post  [except some spellings] :)  I will go into detail from my years of researched notes and prior forum posts to answer your questions.  This is Max's thread, and I will wait to see if he has any questions first!
976897 tn?1379171202
Thank you for that information kenkeith, much appreciated. Do you know what happens with regards to my Lima pumping blood into the LAD along with the flow through the main left stem? I assume that there shouldn't be a problem because the LAD will only accept the flow/pressure it requires?

Thanks again :)
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