Winslow pathway collaterals in Takayasu arteritis with middle aortic syndrome

Abstract

Takayasu arteritis (TA) is a well-known but uncommon chronic granulomatous large-vessel vasculitis that predominantly affects young women. Middle aortic syndrome constitutes part of the TA disease spectrum where lower body blood flow is supplemented by multiple systemic and visceral collateral pathways. One such systemic-systemic collateral pathway of particular clinical importance is the Winslow pathway which extends from the internal thoracic artery to the external iliac artery bilaterally. We present three patients with TA and middle aortic syndrome who had well-developed Winslow pathway collaterals and discuss the importance of these pathways.