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Polyarteritis Nodosa: Spectrum of Angiographic Findings¹

¹ From the Department of Vascular and Interventional Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. Recipient of a Certificate of Merit award for a scientific exhibit at the 1999 RSNA scientific assembly. Received April 3, 2000; revision requested May 9 and received June 27; accepted June 29. Address correspondence to A.W.S. (e-mail: stanson.anthony@mayo.edu).

The purpose of this study was to review the positive angiographic findings in patients with polyarteritis nodosa (PAN). The authors reviewed the angiograms of 56 consecutive patients (25 women and 31 men; age range, 18–81 years; mean age, 55 years) with PAN and arterial abnormalities consistent with necrotizing vasculitis. Aneurysms were present in 27 patients and segments of ectasia were present in seven patients, for a total of 34 (61%) of 56 patients with aneurysmal lesions. The remaining 22 (39%) patients had arterial lesions that were occlusive: luminal irregularity, stenosis, or occlusion. All but one of the patients with an aneurysm also had occlusive lesions. Therefore, 55 (98%) of the 56 patients were found to have occlusive lesions. Skeletal muscle arteries were affected in 18 patients, nine in the extremities. The most frequent finding in patients with PAN was occlusive arterial lesions. Although the presence of aneurysms increases specificity for the diagnosis of PAN, many patients have only occlusive lesions. Involvement of skeletal muscle arteries was common.

Index Terms: Arteries, splenic, 954.621 • Arteries, superior mesenteric, 955.621 • Arteritis, 9*.621² • Hepatic arteries, 952.621 • Renal arteries, 961.621

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