Unusual renal vascular adaptations in childhood Takayasu arteritis: a CT angiographic demonstration of extensive collaterals and aberrant arteries.

Takayasu arteritis (TA) is a rare large-vessel vasculitis, typically affecting young females. We report a young Indian male with resistant hypertension and bilateral renal artery stenosis, who developed extensive collateral and accessory renal arteries as adaptive vascular remodelling in the setting of chronic, inactive large-vessel vasculitis, with preserved renal function due to extensive collateralisation. This constellation of findings is rare, particularly in males. The case underscores the role of CT angiography in delineating complex vascular remodelling in chronic TA and the importance of early imaging in young individuals with unexplained hypertension.