Flow reversal in coronary collaterals P. URBAN, B. MEIER AND L. FINCI

We report a case of a patient in whom collateral flow originating from the left anterior descending coronary artery was initially associated with a right coronary artery stenosis; seven months after successful angioplasty of the right coronary artery lesion, a severe left anterior descending stenosis developed and induced reversed collateral flow from the right coronary artery through the same collateral channel. Flow reversal in collaterals has been shown to occur in an animal model', following surgical bypass grafting and spontaneously in man'. The present report documents flow reversal in pre-existing collaterals after angioplasty. It may be a rare occurrence, but its clinical implications are significant.