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Distribution of macrovascular disease in scleroderma
L Stafford1, H Englert, J Gover
1Department of Rheumatology, Prince Henry Hospital, Sydney, Australia.
Annals of the Rheumatic Diseases
|November 3, 1998
Summary
Scleroderma specifically targets ulnar arteries, causing narrowing and thickening. Early assessment via Doppler sonography or Allen's test is recommended for patients with scleroderma, particularly those with digital gangrene.
Area of Science:
- Vascular Medicine
- Rheumatology
- Medical Imaging
Background:
- Macrovascular disease is an emerging concern in scleroderma.
- Previous studies indicated its presence, but the specific anatomical distribution was unclear.
Purpose of the Study:
- To determine the anatomical distribution of macrovascular disease in scleroderma patients.
- To identify specific arteries affected by vascular changes in scleroderma.
Main Methods:
- Retrospective cohort study comparing 20 scleroderma patients with 20 matched controls.
- Doppler studies assessed arteries in limbs, neck, and abdomen.
- Quantitative (intraluminal diameter) and qualitative (thickening, stenosis, calcification) analyses were performed.
Main Results:
- Scleroderma patients exhibited significantly narrower ulnar arteries compared to controls.
- Ulnar artery walls showed smooth thickening throughout their length.
- Other arteries, including those in the lower limbs, did not show significant differences.
Conclusions:
- The ulnar artery appears to be a specific target in scleroderma-related macrovascular disease.
- Consider modified Allen's test or Doppler sonography for ulnar artery assessment in scleroderma patients, especially with digital gangrene.