[Coronary stenosis and mechanisms of collateral vessel growth].

The presence or absence of collateral circulation significantly impacts the natural history of coronary artery disease. Collateral growth involves two different mechanism; capillary collaterals develop by sprouting (angiogenesis) and muscular collaterals develop in situ from preexisting arterioles (arteriogenesis). The process is mediated by various angiogenic growth factors such as VEGF, FGFs, IGF-1 and PDGF. Although these growth factors have been studied extensively, controversies still exist as to whether angiogenesis depends on increased supply of these growth factors or their receptors are upregulated by the underlying pathological situation. An increased understanding of the basic biology of collateral vessel development would be instrumental in the establishment of therapeutic angiogenesis.