Ratschiller Thomas, Müller Hannes, Pirklbauer Markus, Silye Rene, Sulzbacher Gregor, Zierer Andreas
Department of Cardiac, Vascular and Thoracic Surgery, Kepler University Hospital, Linz, Austria.
Department of Internal Medicine IV-Nephrology and Hypertension, Medical University Innsbruck, Tirol, Austria.
J Vasc Surg Cases Innov Tech. 2018 Aug 30;4(3):248-251. doi: 10.1016/j.jvscit.2018.05.005. eCollection 2018 Sep.
Giant cell arteritis is an inflammatory vasculopathy of unknown etiology that typically affects the carotid artery and its branches. Symptomatic involvement of upper extremity arteries is uncommon. We report a case of a 70-year-old woman with polymyalgia rheumatica who presented with critical arm ischemia, constitutional symptoms, and elevated erythrocyte sedimentation rate. Urgent revascularization by a carotid-brachial artery bypass was performed. Histopathologic evaluation of a specimen obtained intraoperatively from the occluded axillary artery confirmed the diagnosis, and corticosteroid therapy was initiated. Large-vessel vasculitis should be considered a rare differential diagnosis in occlusive disease of the upper extremity.
巨细胞动脉炎是一种病因不明的炎症性血管病，通常累及颈动脉及其分支。上肢动脉出现症状性受累并不常见。我们报告一例70岁患风湿性多肌痛的女性病例，该患者表现为严重的手臂缺血、全身症状及红细胞沉降率升高。通过颈动脉-肱动脉旁路移植术进行了紧急血运重建。术中从闭塞的腋动脉获取的标本进行组织病理学评估确诊了该病，并开始了皮质类固醇治疗。在诊断上肢闭塞性疾病时，应考虑到大血管血管炎这一罕见的鉴别诊断。
