Interventions for mesenteric vasculitis

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Interventions for mesenteric vasculitis Yevgeniy Rits, MD, Gustavo S. Oderich, MD, Thomas C. Bower, MD, Dylan V. Miller, MD, Leslie Cooper, MD, Joseph J. Ricotta, MD, Manju Kalra, MBBS, Peter Gloviczki, MD Journal of Vascular Surgery Volume 51, Issue 2, Pages 392-400.e2 (February 2010) DOI: 10.1016/j.jvs.2009.08.082 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Imaging findings consistent with the diagnosis of mesenteric vasculitis. Computed tomography angiography shows (A) significant arterial wall thickening (arrowheads) and (B) a long, smooth tapered lesion (arrow). C, A lateral aortogram shows long smooth tapered lesions of the proximal celiac axis and superior mesenteric artery (arrows). Journal of Vascular Surgery 2010 51, 392-400.e2DOI: (10.1016/j.jvs.2009.08.082) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2. (online only) Distribution of mesenteric and extramesenteric lesions in patient with occlusive mesenteric vasculitis involving the celiac axis, superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). Journal of Vascular Surgery 2010 51, 392-400.e2DOI: (10.1016/j.jvs.2009.08.082) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3. (online only) Histologic examination arterial wall biopsy obtained from the patient described in Fig 1 confirmed the diagnosis of giant cell arteritis, showing chronic lymphoplasmacytic vasculitis with patchy transmural inflammation and periadventitial fibrosis. A, Hematoxylin and eosin (H&E) stain at original magnification ×12.5. B, The arrow designates a multinucleated giant cell (H&E; original magnification ×200). Journal of Vascular Surgery 2010 51, 392-400.e2DOI: (10.1016/j.jvs.2009.08.082) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 A, Open mesenteric revascularization for mesenteric vasculitis was with an iliac artery to superior mesenteric artery bypass or (B) a supraceliac aorta to superior mesenteric and bilateral renal artery bypass in a patient with concomitant bilateral renal artery stenoses and renovascular hypertension. Journal of Vascular Surgery 2010 51, 392-400.e2DOI: (10.1016/j.jvs.2009.08.082) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 Primary graft patency is shown in patients treated with open revascularization for mesenteric vasculitis (MV)) and for atherosclerotic (ASO) disease. Journal of Vascular Surgery 2010 51, 392-400.e2DOI: (10.1016/j.jvs.2009.08.082) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 6 Freedom from mesenteric symptoms in the patients treated for mesenteric vasculitis (MV) vs atherosclerosis (ASO). Journal of Vascular Surgery 2010 51, 392-400.e2DOI: (10.1016/j.jvs.2009.08.082) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 7. (online only) Kaplan-Meyer survival curves of the patients treated for mesenteric vasculitis (MV) compared with Minnesota (MN) age- and gender-matched controls vs patients treated for atherosclerosis (ASO). Journal of Vascular Surgery 2010 51, 392-400.e2DOI: (10.1016/j.jvs.2009.08.082) Copyright © 2010 Society for Vascular Surgery Terms and Conditions