Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Sci Rep. 2022 May 31;12(1):9051. doi: 10.1038/s41598-022-12991-y.
To describe the peripheral angiographic features of vasculopathy in idiopathic inflammatory myopathies (IIM) and systemic sclerosis (SSc) in comparison to polyarteritis nodosa (PAN). Angiograms of 47 extremities (24 upper and 23 lower) of 11 patients with IIM (n = 5) and SSc (n = 6), and 12 patients with PAN who presented with critical limb ischemia were retrospectively analyzed with regards to the presence of stenosis, occlusion, aneurysms and delayed distal flow, and degree of neovascularization. Diffuse narrowing was more frequent (66.1 vs. 38.0%, p = 0.001), whereas multifocal stenosis (6.5% vs. 26.8%, p = 0.002), abrupt occlusion (11.3% vs. 29.6%, p = 0.010) and aneurysm formation (1.6% vs. 11.3%, p = 0.037) were less frequent in IIM/SSc than PAN. In distal arteries, tapered occlusion (95.5% vs. 76.0%, p = ns) and delayed flow (77.3% vs. 48.0%, p = 0.039) were more common in IIM/SSc than PAN. After 1 year, auto- or surgical amputation tended to be more frequent in IIM/SSc than PAN (36.4% vs. 16.7%, p = ns). In conclusion, diffuse narrowing, tapered occlusion and delayed distal flow on conventional angiograms tend to be more frequent in IIM/SSc than PAN. Further studies are needed to verify these findings in a larger prospective cohort.
比较特发性炎性肌病（IIM）和系统性硬化症（SSc）与结节性多动脉炎（PAN）的周围血管造影特征。回顾性分析了 11 例患者的 47 个肢体（24 个上肢和 23 个下肢）的血管造影，其中包括 5 例 IIM 和 6 例 SSc 患者，以及 12 例因严重肢体缺血而出现的 PAN 患者。分析了狭窄、闭塞、动脉瘤和远端血流延迟以及新生血管化的程度。弥漫性狭窄更为常见（66.1%比 38.0%，p=0.001），而多灶性狭窄（6.5%比 26.8%，p=0.002）、突然闭塞（11.3%比 29.6%，p=0.010）和动脉瘤形成（1.6%比 11.3%，p=0.037）在 IIM/SSc 中比 PAN 中更为少见。在远端动脉中，锥形闭塞（95.5%比 76.0%，p=ns）和血流延迟（77.3%比 48.0%，p=0.039）在 IIM/SSc 中比 PAN 更为常见。1 年后，自动或手术截肢在 IIM/SSc 中比 PAN 更常见（36.4%比 16.7%，p=ns）。总之，与 PAN 相比，在 IIM/SSc 中常规血管造影更常出现弥漫性狭窄、锥形闭塞和远端血流延迟。需要进一步的研究来验证这些发现是否适用于更大的前瞻性队列。
