title: Arterial vasculopathy in systemic sclerosis: computerized tomography (CT) angiographic features of macrovascular and microvascular upper limbs arteries.
abstract: OBJECTIVE
  To describe the CT angiographic findings of arterial vasculopathy in the major vessels as well as medium and micro vascular affection of the whole upper limbs arterial tree in patients with systemic sclerosis (SSc) with and without digital ulceration.
  
  
  METHODS
  Twenty-two cases with systemic sclerosis (12 limited and 10 diffuse) were recruited for the study. All patients fulfilled the American Rheumatism Association (ACR) criteria for the classification of SSc. For all patients routine laboratory investigations were performed including complete lipid profile. Computed tomography angiography (CTA) studies for the whole upper limb arterial tree were performed for both upper limbs in all cases.
  
  
  RESULTS
  CTA studies showed involvement of subclavian arteries in 3 cases and axillary artery was involved in five cases. Brachial artery was affected in 5 cases. In the forearm the radial artery was affected in 4 cases with bilateral involvement in two cases (6 vessels), while ulnar artery was affected in five cases. Unilateral non visualization of the superficial palmar arch was observed in two cases with limited disease, while thinning out of the vessel wall with poor distal run off in 18 cases. A higher number of arterial vasculopathy was significantly associated with systolic pulmonary artery pressure (P=0.001).
  
  
  CONCLUSIONS
  Macrovascular arterial vasculopathy of upper limbs may occur in SSc irrespective of the disease pattern. Major arteries can be affected in association with other medium sized arteries of the forearms and microvascular arterial branches of the hands.
authors: Rheumatology and Rehabilitation Department, Faculty of medicine Cairo University, Cairo, Egypt; Rheumatology and Rehabilitation Department, Faculty of medicine, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia. Electronic address: yasseremad68@yahoo.com.
authors: Yasser
authors: Y
authors: Emad
authors: Rheumatology and Rehabilitation Department, Faculty of medicine Cairo University, Cairo, Egypt.
authors: Hend
authors: H
authors: Al-Sherbeni
authors: Radiology Department, Faculty of medicine, Cairo University, Cairo, Egypt; Radiology Department, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia.
authors: Yasser
authors: Y
authors: Ragab
authors: Rheumatology and Rehabilitation Department, Faculty of medicine Cairo University, Cairo, Egypt.
authors: Ihab
authors: I
authors: Abo-El-Youn
authors: Rheumatology and Rehabilitation Department, Suez Canal University, Ismailia, Egypt.
authors: Nashwa
authors: N
authors: El-Shaarawy
authors: Cardiology Department, Al-Azhar university, Faculty of Medicine, Cairo, Egypt.
authors: Dina Y
authors: DY
authors: Nassar
authors: Internal medicine department faculty of medicine Cairo University, Cairo, Egypt.
authors: Ahmed
authors: A
authors: Fathy
authors: Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors: Hadeel
authors: H
authors: Al-Hanafi
authors: Rheumatology Department, University of Twente, Enschede, The Netherlands.
authors: Johannes J
authors: JJ
authors: Rasker
mesh_terms: D000328:Adult; D000792:Angiography; D005260:Female; D006801:Humans; D055806:Microvessels / Q000000981:diagnostic imaging; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D012595:Scleroderma, Systemic / Q000150:complications*; D014057:Tomography, X-Ray Computed; D034941:Upper Extremity / Q000098:blood supply*
keywords: CT angiography; Digital ulcers; Scleroderma; Systemic sclerosis; Upper limb ischemia; Vasculopathy