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This study was designed to compare coronary collateral function in patients after bare-metal stent (BMS) or drug-eluting stent (DES) implantation.
Our inclusion criteria led to a preselection of mildly affected patients with low-flow haemodynamic infarction, because of their impaired collateral function being particularly vulnerable to secondary worsening.
Different treatment outcomes might be related to collateral function such as changes in the breathing pattern [27 29], different mandibular displacement [30, 31], and/or spontaneous dental changes in the lower arch [32], but these variables were not evaluated in the present study.
This coronary collateral function can preserve ischemic myocardium [ 210].
Theoretically, improved coronary collateral function could affect Doppler-derived coronary flow reserve, although specific trials should confirm this hypothesis.
Previous animal studies have proven the feasibility of enhancing collateral function by delivery of angiogenic factors to the myocardium [ 1, 2, 22- 24].
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Exercise training improves collateral vessel function, even in arteries with no coronary stenosis [ 7].
Since better collateral vessel function is associated with improved survival [ 9], this is a plausible mechanism for the survival benefit seen with exercise.
Previous studies showed that when the diameters of ACoA or PCoA were less than 0.7 mm or the ACA-A1 or the PCA-P1 was less than 1.0 mm, the collateral circulation function would not be fully achieved if occluded disease occurred and the effective hemoperfusion in blood supply areas of blocked blood vessels could not be provided [ 14].
Under physiological conditions, an acute arterial occlusion causes pre-existing collaterals to function as possible anastomoses to bypass the occlusion (both in animal models and in humans).
There were significant (P<0.05) differences between the specialist unit and standard care on 42/132 intervention process items, including more comprehensive assessment of mental state, function, collateral history, statement of a clear medical diagnosis, drug review, rehabilitation therapy, discussion with family carers, and referral to community rehabilitation and mental health services (table 2).
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