Thermalright AXP-100H Muscle keeps it on the down-blow
 

Say what you will about Thermalright, but the company listens to its fans. The low-profile AXP-100R down-draft heatsink wouldn't fit on certain high-end motherboard with tall heatsinks on their voltage regulators. Unwilling to leave a market un-served, Thermalright now offers the AXP-100H Muscle, which is a quarter-inch (7 mm) taller than the previous version.

http://techreport.com/news/31000/the...-the-down-blow