TY  - BOOK
AU  - Bigham, Grace
AU  - Haider, Syed W
AU  - Lahti, Steven
TI  - Shifting perspectives in coronary involvement of polyarteritis nodosa: case of 3-vessel occlusion treated with 4-vessel CABG and review of literature. [Review]
SN  - 1471-2261
PY  - 2024///
KW  - *Atherosclerosis
KW  - *Coronary Artery Disease
KW  - *Percutaneous Coronary Intervention
KW  - *Polyarteritis Nodosa
KW  - Atherosclerosis/et [Etiology]
KW  - Coronary Artery Bypass
KW  - Coronary Artery Disease/dg [Diagnostic Imaging]
KW  - Coronary Artery Disease/et [Etiology]
KW  - Coronary Artery Disease/th [Therapy]
KW  - Humans
KW  - Percutaneous Coronary Intervention/mt [Methods]
KW  - Polyarteritis Nodosa/co [Complications]
KW  - Polyarteritis Nodosa/dg [Diagnostic Imaging]
KW  - Polyarteritis Nodosa/th [Therapy]
KW  - Treatment Outcome
KW  - Curated
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Cardiovascular Disease Fellowship
KW  - Internal Medicine Residency
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Case Reports
KW  - Journal Article
KW  - Review
N1  - Available online from MWHC library: 2001 - present
N2  - BACKGROUND: Polyarteritis Nodosa (PAN) is a systemic vasculitis (SV) historically thought to spare the coronary arteries. Coronary angiography and contemporary imaging reveal coronary stenosis and dilation, which are associated with significant morbidity and mortality. Coronary arteries in PAN are burdened with accelerated atherosclerosis from generalized inflammation adding to an inherent arteritic process. Traditional atherosclerotic risk factors fail to approximate risk. Few reports document coronary pathology and optimal therapy has been guarded; CONCLUSIONS: When graft selection avoids the vascular territory of SV's, CABG offers definitive therapy. We have contributed report of a novel CABG configuration in addition to reviewing, updating and discussing the literature. Accumulating evidence suggests discrete clinical symptoms warrant suspicion for coronary involvement. Copyright © 2024. The Author(s); METHODS: Database publication query of English literature from 1990-2022; RESULTS: Severity of coronary involvement eludes laboratory monitoring, but coronary disease associates with several clinical symptoms. Framingham risk factors inadequately approximate disease burden. Separating atherosclerosis from arteritis requires advanced angiographic methods. Therapy includes anticoagulation, immunosuppression and revascularization. PCI has been the mainstay, though stenting is confounded by vagarious alteration in luminal diameter and reports of neointimization soon after placement
UR  - https://dx.doi.org/10.1186/s12872-024-03841-y
ER  -