• Ayesha Nuzhat, Asma Al Akeel, and Maha Al Husain.
• Department of Basic Medical Sciences, Faculty of Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail. anuzhat@kfmc.med.sa.
• Saudi Med J. 2020 May 1; 41 (5): 459-465.

ObjectivesTo evaluate the anatomical variation of arterial collaterals and their prevalence in moyamoya and atherosclerosis.MethodsData was collected retrospectively from patients (n=46) database who underwent digital subtraction angiography between January 2010 and December 2018 at the Radiology Department, King Fahad Medical City, Riyadh, Saudi Arabia. Demographic details and clinical data of the patients such as age, gender, etiology, clinical presentation, angiographic staging using Suzuki grading for moyamoya cases, variation of arterial collaterals, and their prevalence, treatment and follow up were obtained.Results   Four types of collaterals network  were observed in atherosclerosis (n=21) and moyamoya (n=25); the leptomeningeal, durocortical, subependymal, inner-interstriatal and intrathalamic networks. More number of collaterals were observed in the moyamoya (n=534) than atherosclerosis (n=40). Leptomeningeal network (n=198, 37.1%) and subependymal network (n=170, 31.8%) were greater than durocortical and inner-interstriatal or intrathalamic in patients with moyamoya. Whereas leptomeningeal network (n=25, 62.5%) and inner-interstriatal or intrathalamic (n=7, 17.5%) were predominant in atherosclerosis. Out of 25 cases of moyamoya, Suzuki grading V was noted in 5 (20%) and grade IV in 13 (52%).ConclusionUnderstanding the dynamics that have evolved in the development of the collaterals and  therefore can improve both management and prognosis.

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