A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice

Objectives: Collateral pathways in aortoiliac occlusive disease are essential for arterial blood flow to the lower abdomen and limbs. These different pathways further indicates the severity of disease and need of an appropriate treatment. The present study attempts in describing the various collater...

Full description

Saved in:
Bibliographic Details
Main Authors: Madavan Praveena, Devender Singh, Bhavani Prasad Kalagani
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Indian Journal of Vascular and Endovascular Surgery
Subjects:
Online Access:https://journals.lww.com/10.4103/ijves.ijves_106_24
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849735559263551488
author Madavan Praveena
Devender Singh
Bhavani Prasad Kalagani
author_facet Madavan Praveena
Devender Singh
Bhavani Prasad Kalagani
author_sort Madavan Praveena
collection DOAJ
description Objectives: Collateral pathways in aortoiliac occlusive disease are essential for arterial blood flow to the lower abdomen and limbs. These different pathways further indicates the severity of disease and need of an appropriate treatment. The present study attempts in describing the various collateral pathways and its implication in the clinical practice. Materials: This is a retrospective study from January 2023 to June 2024 and reviewed all the records. Twelve patients (10 males, 2 females) with a mean age of 60 years were included in this study. All the patients were evaluated with three dimensional volume rendered rotational CT angiography and non invasive segmental blood pressure, pulse volume recording with ankle brachial index. Results: Nine patients had diabetes mellitus, 8 hypertension, and 6 dyslipidemia. Ten were active smokers. Five patients presented with intermittent claudication and 7 presented with critical limb ischemia. Two dominant collateral pathways were observed. Systemic collateral pathways were dominant in 7 patients, whereas visceral collaterals pathways were prominent in 5 patients. It is noted that complete occlusion of infrarenal aorta tends to have visceral collaterals pathways, whereas distal aortic occlusions had systemic collaterals pathways. Patients with visceral pathways had lower ABI and required early revascularisation. Knowledge of these pathways, demands careful surgical dissection; however we did not find any difference in the post operative outcome after successful revascularisation. Conclusions: Collateral pathways are defined mainly by the location of the lesion and helps in deciding the appropriate treatment. Patients with visceral collaterals pathways are more symptomatic and needs early revascularisation. Failure to recognize these pathways particularly during non vascular surgeries could lead to limb threatening situations.
format Article
id doaj-art-bf03744a93fc4cbab670bfab61e9284a
institution DOAJ
issn 0972-0820
2394-0999
language English
publishDate 2025-04-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Journal of Vascular and Endovascular Surgery
spelling doaj-art-bf03744a93fc4cbab670bfab61e9284a2025-08-20T03:07:32ZengWolters Kluwer Medknow PublicationsIndian Journal of Vascular and Endovascular Surgery0972-08202394-09992025-04-0112211211610.4103/ijves.ijves_106_24A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical PracticeMadavan PraveenaDevender SinghBhavani Prasad KalaganiObjectives: Collateral pathways in aortoiliac occlusive disease are essential for arterial blood flow to the lower abdomen and limbs. These different pathways further indicates the severity of disease and need of an appropriate treatment. The present study attempts in describing the various collateral pathways and its implication in the clinical practice. Materials: This is a retrospective study from January 2023 to June 2024 and reviewed all the records. Twelve patients (10 males, 2 females) with a mean age of 60 years were included in this study. All the patients were evaluated with three dimensional volume rendered rotational CT angiography and non invasive segmental blood pressure, pulse volume recording with ankle brachial index. Results: Nine patients had diabetes mellitus, 8 hypertension, and 6 dyslipidemia. Ten were active smokers. Five patients presented with intermittent claudication and 7 presented with critical limb ischemia. Two dominant collateral pathways were observed. Systemic collateral pathways were dominant in 7 patients, whereas visceral collaterals pathways were prominent in 5 patients. It is noted that complete occlusion of infrarenal aorta tends to have visceral collaterals pathways, whereas distal aortic occlusions had systemic collaterals pathways. Patients with visceral pathways had lower ABI and required early revascularisation. Knowledge of these pathways, demands careful surgical dissection; however we did not find any difference in the post operative outcome after successful revascularisation. Conclusions: Collateral pathways are defined mainly by the location of the lesion and helps in deciding the appropriate treatment. Patients with visceral collaterals pathways are more symptomatic and needs early revascularisation. Failure to recognize these pathways particularly during non vascular surgeries could lead to limb threatening situations.https://journals.lww.com/10.4103/ijves.ijves_106_24aortoiliac diseasenonvascular surgeriessystemic collateralsvisceral collaterals
spellingShingle Madavan Praveena
Devender Singh
Bhavani Prasad Kalagani
A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice
Indian Journal of Vascular and Endovascular Surgery
aortoiliac disease
nonvascular surgeries
systemic collaterals
visceral collaterals
title A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice
title_full A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice
title_fullStr A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice
title_full_unstemmed A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice
title_short A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice
title_sort study on description of collateral pathway patterns in patients with aortoiliac occlusive disease and its prospective implication in clinical practice
topic aortoiliac disease
nonvascular surgeries
systemic collaterals
visceral collaterals
url https://journals.lww.com/10.4103/ijves.ijves_106_24
work_keys_str_mv AT madavanpraveena astudyondescriptionofcollateralpathwaypatternsinpatientswithaortoiliacocclusivediseaseanditsprospectiveimplicationinclinicalpractice
AT devendersingh astudyondescriptionofcollateralpathwaypatternsinpatientswithaortoiliacocclusivediseaseanditsprospectiveimplicationinclinicalpractice
AT bhavaniprasadkalagani astudyondescriptionofcollateralpathwaypatternsinpatientswithaortoiliacocclusivediseaseanditsprospectiveimplicationinclinicalpractice
AT madavanpraveena studyondescriptionofcollateralpathwaypatternsinpatientswithaortoiliacocclusivediseaseanditsprospectiveimplicationinclinicalpractice
AT devendersingh studyondescriptionofcollateralpathwaypatternsinpatientswithaortoiliacocclusivediseaseanditsprospectiveimplicationinclinicalpractice
AT bhavaniprasadkalagani studyondescriptionofcollateralpathwaypatternsinpatientswithaortoiliacocclusivediseaseanditsprospectiveimplicationinclinicalpractice