And a search continues for ways to make new cardiac vessels sprout.

An angiogram shows a significant blockage in one of your coronary arteries, but your cardiologist recommends medical therapy, not angioplasty or bypass. Why? Chances are, you have good “collaterals” — a lacework of tiny blood vessels that can reroute your blood past the blockage and maintain the life-sustaining delivery of oxygen to your heart muscle.

This collateral, or secondary, blood flow is nature’s back-up plan: developing or opening detours in response to severe ischemia (reduced blood flow).

Duplicating the way nature makes these back-up systems has proved daunting. But researchers are working hard on the challenge — investigating gene therapy, drugs, and other options — because collaterals often save lives.…

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