Amy S. Asandra MD, Presenter: Nothing to Disclose

Margaret Hsin-Shung Lee MD, Abstract Co-Author: Nothing to Disclose

Thomas Owen McNamara MD, Abstract Co-Author: Nothing to Disclose

Hsin-Yi Lee MD, Abstract Co-Author: Research grant, Bracco Group

1. Review the clinical symptomatology of aortoiliac occlusive disease (ie- Leriche syndrome). 2. Teach the major collateral arterial pathways through illustrations and case examples.

1. Clinical symptomatology (ie-Leriche) 2. Case examples and illustrations of collateral pathways formed in aortoiliac occlusive disease ie: A. Parietal Collaterals (vessels that normally supply the chest/abdominal wall) ie- -"Winslow's Pathway" aka "Nature's Axillofemoral Bypass": Internal thoracic artery to epigastric arteries to external iliac artery -Intercostal/Lumbar arteries B. Visceral Collaterals -Marginal artery of Drummond -Rectal arteries

A shocking disparity often exists between the severity of aortoiliac occlusive disease and the relative lack of clinical symptoms. This discrepancy highlights the importance of collateral pathways which allow the body to circumvent true vascular compromise. Despite the confusing maze of collaterals that develop, collateral circulation can be more simply conceptualized by categorizing into two systems: parietal and visceral. These collateral routes are taught via case examples and illustrations.

Asandra, A, Lee, M, McNamara, T, Lee, H, Taking a Detour When the Main Highway Is Closed: Collateral Pathways in Aortoiliac Occlusive Disease.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006141.html