Monday, June 28, 2010

Angiographic Findings of the Vasculitides

Vasculitis Vessels Angiography/CT Clinical
Takayasu Thoracic and abdominal aorta and proximal branch vessels, pulmonary and coronary arteries Long-segment smooth stenoses of the aorta & common carotid & subclavian arteries. Stenoses of the pulmonary and coronary arteries. Aortic aneurysm. Thick, enhancing wall on CT/MR. Young Asian woman
Polyarteritis Nodosa Medium and small arteries of visceral organs, heart, and hands and feet. Multiple small aneurysms of renal or visceral arteries, and digital artery occlusions. Hep B, C, IVDA
Giant Cell Distal subclavian, axillary, brachial, carotid branches, aorta. Long irregular stenoses and occlusions. Elderly woman with several weeks of fever, headache, tender temporal arteries, elevated ESR. Ophthalmic artery involvement is feared complication.
Buerger Veins and medium and small arteries of extremities Occlusion of small and medium vessels. Arterial and venous thrombosis Male smoker younger than 50. Migratory thrombophlebitis
Behçet Veins, pulmonary arteries, medium and large arteries. Arterial and venous (more common) thrombosis. Aneurysms of aorta, pulmonary arteries, and peripheral vessels. Recurrent oral and genital apthous ulcers.
Kawasaki Medium and small arteries Aneurysms of the coronary and medium-sized arteries Infant younger than 1
SLE Usually upper extremity medium and small arteries Tapered stenoses on occlusions, especially of the digital arteries. Digital ischemia and ulceration in a young woman with SLE.
RA, HLA-B27s Thoracic aorta. Aortic root dilatation  
The patient shown here has inflammatory changes surrounding his right distal subclavian/axillary artery, consistent with giant cell arteritis.

References

Vascular and Interventional Radiology: The Requisites. 2004.

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