Vasculitis

Takayasu Arteritis

• Affects large and medium sized vessels (especially aorta)

• Females age <30 years old

• HTN & Stroke

• Smooth narrowing of aorta, with preference for left subclavian artery

Dialysis Fistula Evaluation

• Article for reference

• There are also loop grafts which are not mentioned in article above

Loop Graft

• Figure 1. Configuration of the forearm loop access. Either superficial veins located in the antecubital fossa (A) or the basilic vein right above the elbow joint (B) can be selected as an outflow vein. When comparing with the antecubital veins as the outflow, the basilic vein above the elbow joint provides an almost parallel course to the graft. (Arrow: venous anastomosis).

Cystic Adventitial Disease

• Non-atherosclerosis causes of vessel stenosis and claudication

  • Caused by mucin containing cysts in the adventita of the vessel wall

• Causes a scimitar sword or sprial appearance of the vessel on angio

• M>F

• Look for men with no RF for cardiovascular disease

• Popliteal artery is the vessel affected in ~90% of cases

• Most common tx = cyst resection and vascular bypass

Fibromuscular Dysplasia

• Dysplastic growth of smooth muscle and fibrous tissue affecting small and medium vessels

• F>M

• Look for this in young adult females with refractory HTN

• String of beads on angio

• Tx = balloon angioplasty

  • DO NOT PICK STENTING