ESB Toolkit 2.2 Itinerary Designer Installation
Brian Loesgen has a post on his blog describing an issue he ran into performing a clean build of BizTalk Server 2013 and ESB Toolkit 2.2, where the Itinerary Designer extension is not registered in Visual Studio 2012 after the ESB Toolkit 2.2 installation step.
I experienced this also so it may be more widespread than first thought. I’d be interested to hear how many other people run into it; it might be the case that this step will need to be added to installation instructions.
Before Brian pointed me to his post I had resolved this inadvertently when I installed the latest Visual Studio 2012 update, which would have resulted in a similar command being executed with the same outcome.
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Colin Meade's Blog 
Just ran into this very issue. Installed the ESB Toolkit 2.2 this morning. The itinerary designer was not properly registered in Visual Studio 2012. Brian’s fix did the trick.
I hit this problem today with VS2013 premium update 4 and BizTalk 2013r2. Unfortunately, running devenv /setup from an admin VS command prompt didn’t fix it. Any ideas?
I got this to work by first uninstalling the ESB toolkit, then re-installing from the BizTalk installation ISO. I then ran devenv /setup as per Brian’s blog and now I am able to open itineraries again in Visual Studio. I think the cause of the problem may be that this particular development machine was upgraded to BizTalk 2013 R2 from BizTalk 2013 – rather than a clean install.