Winslow's pathway

摘要

Winslow's pathway (Fig. 1) refers to an uncommon collateral circulation supplying the lower limbs in pathologic severe aorto-iliac occlusive disease. It arises from the subclavian artery and extends through the internal mammary arteries, superior epigastric and inferior epigastric arteries to the iliac arteries or femoral arteries. More commonly, blood is shunted through the visceral pathway which is an anastomosis between the inferior mesenteric artery to the iliac or femoral arteries via rectal collaterals [1]. Recognition of the pathway is important in planning for endovascular intervention which may not be feasible via a femoral approach. If abdominal surgery is to be undertaken, pre-operative CT would be helpful to prevent inadvertent transection of the pathway leading to acute lower limb ischemia [2, 3].