Holscher Courtenay M, Stonko David P, Weaver M Libby, Reifsnyder Thomas
Department of Surgery, Johns Hopkins Bayview Medical Center, Baltimore, Md.
Division of Vascular Surgery, Department of Surgery, Johns Hopkins Bayview Medical Center, Baltimore, Md.
J Vasc Surg Cases Innov Tech. 2020 Oct 26;7(1):152-156. doi: 10.1016/j.jvscit.2020.10.005. eCollection 2021 Mar.
Polyarteritis nodosa (PAN) is a rare vasculitis that can cause peripheral ischemia. We present the case of a 49-year-old man who developed PAN causing toe gangrene and severe rest pain in one foot and claudication of the contralateral foot. He was treated with immunosuppression and underwent popliteal-plantar artery bypass with resolution of rest pain and subsequent amputation of his mummified toe. Despite remission of PAN, his contralateral foot claudication was lifestyle limiting; thus, 5 years later he underwent contralateral popliteal-plantar bypass with resolution of claudication. This case demonstrates the anatomically symmetric presentation of PAN induced ischemia with successful open revascularization after resolution of inflammatory markers with systemic therapy.
结节性多动脉炎（PAN）是一种可导致外周缺血的罕见血管炎。我们报告了一例49岁男性患者，其患结节性多动脉炎后出现足趾坏疽，一只脚有严重静息痛，对侧脚有间歇性跛行。他接受了免疫抑制治疗，并接受了腘-足底动脉搭桥手术，静息痛得以缓解，随后其木乃伊样足趾被截肢。尽管结节性多动脉炎已缓解，但他对侧脚的间歇性跛行限制了生活方式；因此，5年后他接受了对侧腘-足底搭桥手术，间歇性跛行得以缓解。该病例显示了结节性多动脉炎所致缺血在解剖学上的对称表现，经全身治疗炎症指标消退后成功进行了开放血管重建。
