Activation of endo-epicardial or heterocoronary collaterals

Activation of endo-epicardial or heterocoronary collaterals is a physiological mechanism where secondary blood vessels are recruited to provide perfusion to ischemic regions of the heart. Endo-epicardial collaterals provide connections between the inner and outer myocardial layers, while heterocoronary collaterals allow blood flow from one coronary artery system to another, such as from the right coronary artery to the left anterior descending artery (PMC, 2025). This process is specifically identified as one of the three primary mechanisms of action for the Pressure-Controlled Intermittent Coronary Sinus Occlusion (PiCSO) system, a catheter-based medical device used to reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI) (De Maria et al., 2024). By increasing coronary sinus pressure through cyclic balloon inflation, the device forces blood backward through these collateral pathways into the ischemic 'no-reflow' zone to salvage tissue. While this is primarily a mechanical phenomenon rather than a specific molecular target like a receptor or enzyme, its activation is a critical determinant of clinical outcomes in revascularization procedures (Circulation: Cardiovascular Interventions, 2024). Pharmacological approaches to enhance this process typically involve growth factors like VEGF and FGF, but the specific term 'activation of endo-epicardial or heterocoronary collaterals' remains a device-centric therapeutic concept in modern interventional cardiology.

Other names

Endo-epicardial collateral recruitmentHeterocoronary collateral activationCoronary collateral recruitmentCoronary collateralization

Pressure-induced redistribution of blood flow through pre-existing or dormant collateral vessels to enhance perfusion in ischemic zones.