PMC7705765_01
(A) Early phase aortogram in the anteroposterior view
demonstrates no opacification of the celiac artery
representing complete occlusion, very limited
opacification of the right renal artery consistent with
complete occlusion at the origin (white solid arrow), long
segment stenosis of the superior mesenteric artery (white,
dashed arrow), focal stenosis of the left main renal
artery (asterisk), prominent inferior mesenteric artery
with arc of Riolan variant (white, dotted arrow) providing
retrograde flow to the superior mesenteric artery and the
left main renal artery. Overall, the undulating caliber of
the aorta is noted. (B) Late phase aortogram in the
anteroposterior view demonstrates collateral arterial
vessels around the right kidney providing minimal
perfusion to parenchyma and retrograde filling of the
right renal artery (white, solid arrow), improved
opacification of the superior mesenteric artery with
retrograde filling from the arc of Riolan variant (white,
dashed arrow), and slight opacification of the common
hepatic artery (black, solid arrow) likely due to
retrograde filling of the celiac artery branches from an
arc of Buehler variant.
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PMC7705765_01_10.1177_2324709620977317-fig1.jpg
fig1-2324709620977317
This revealed multifocal areas of large vessel occlusion and stenoses (Figure 1A and B); angiogram findings were strongly suggestive of a systemic vasculitis.
(A) Positron emission tomography computed tomography scan
demonstrating increased fluorodeoxyglucose uptake in the
aortic wall, most notable just above the diaphragmatic
hiatus (arrow) consistent with inflammatory vasculitis.
(B) Reformatted cardiac magnetic resonance posterior
oblique image demonstrating absence of head and neck
vessel involvement and redemonstrating abdominal aortic
narrowing (arrow).
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fig2-2324709620977317
Her full body positron emission tomography scan showed localized areas of aortic wall thickening with increased fluorodeoxyglucose uptake in multiple areas (Figure 2A) and cardiac magnetic resonance imaging (Figure 2B), concerning for TA.