Patients with vasculitis related to a variety of connective tissue diseases may have manifestations of peripheral ischemia in the extremities. The same patients may have atherosclerotic vascular disease. For purposes of management it is essential that the contributions of the two diseases to the pathogenesis of ischemia be recognized as distinctly as possible. Three categories of patients may be delineated as follows: those with (1) ischemia owing solely to connective tissue disease, (2) ischemia owing mainly to atherosclerosis in a patient with well-controlled connective tissue disease, and (3) ischemia owing both to connective tissue disease and atherosclerosis. The appropriate and timely use of screening laboratory tests for connective tissue diseases, arteriography, medical therapy, sympathectomy, and arterial reconstruction can, in large measure, be defined for these groups of patients.
DePalma RG, Moskowitz RW, Holden WD. Peripheral Ischemia and Collagen DiseaseClinical Manifestations, Diagnosis, and Treatment. Arch Surg. 1972;105(2):313-318. doi:10.1001/archsurg.1972.04180080161027