Development of the collateral circulation: History of an idea

A lifelong commitment to the idea of finding the blueprint according to which collateral arteries develop from small arteriolar precursors into larger arteries that can replace occluded major arteries, including the aorta, is described. A small early discovery (the rise in poststenotic pressure following controlled progressive coronary artery occlusion), encouragement from the author's teacher (Dr Paul Janssen) and success in publishing were the keys to maintaining motivation. Consequent learning and application of all new experimental and laboratory methods - from elctron (scanning and transmission) to confocal microscopy, use of monoclonal antibodies, molecular techniques including DNA sequencing and DNA transfection, manipulation of the mouse genome and microarray studies - now provide a much more detailed blueprint of the developing collateral artery. However, there is probably still a long way to go before patients can be treated using the novel concept of arteriogenesis.