Arteriography in polyarteritis nodosa. 15 cases (author's transl)

Despite its imperfections, arteriography, when it demonstrates aneurysms, is an important element in diagnosis in all those cases in which histological findings are not definitive. It should be carried out before renal biopsy, given the risk of traumatic rupture of a possible aneurysm. The discovery of isolated distal arterial stenoses is not characteristic, though in the presence of a suggestive clinical picture, amy be considered as an argument in favour of the diagnosis. They occur frequently in the arteries of the digestive tract even in the absence of any abdominal symptoms or signs. Arteriography also has a prognostic value in establishing the extent of arterial lesions and, finally, is useful in the diagnosis of certain complications such as visceral haematomas and digestive haemorrhages. We thus feel that polyarteritis nodosa should be the object of a complete vascular exploration, including aortography with selective renal studies but also coelio-mesenteric opacification. In the light of the clinical context, the distal limb arteries may also be explored. Thus the diagnosis of polyarteritis nodosa is not purely histological but also arteriographic.