• Lupus vasculitis primarily affects microvascular circulation, and large-vessel thrombosis is a rare complication of this disease. Large-vessel occlusive disease in systemic lupus erythe-matosus is most likely related to hypercoagulability in addition to immune complex–mediated endothelial damage. We describe the 11th and 12th patients reported to have systemic lupus erythematosus and macrovascular occlusive disease of the lower extremities. Our experience and a review of the literature suggest that, while aortoiliac disease is amenable to bypass or endarterectomy, infrainguinal disease is rarely correctable surgically, and amputation becomes necessary in most of these patients.
(Arch Surg. 1991;126:109-110)