Clinical and angiographic manifestations inpatients without previous diagnosis of Takayasu´s arteritis
Main Article Content
Keywords
Takayasu’s arteritis, Angiography with digital subtraction, Stroke, Renovascular hypertension
Abstract
Background: Takayasu’s arteritis is a systemic vasculitis that affects the aorta and its main branches mainly seen in young women and it is characterized by decrease or absence of pulses. The arteriography is necessary to corroborate the diagnosis. The aim of this article is to analyze the clinical manifestations and radiological findings in patients with no previous diagnosis of TA
Methods: The patients were sent to the Department of Radiodiagnosis and Imaging for the performance of an angiography for cerebrovascular disease (CVD) in young patients, renovascular hypertension (RVH) and arterial insufficiency (IA) of limbs. Clinical manifestations were used to investigate the diagnosis of AT according to the criteria of the American College of Rheumatology 1990. A digital subtraction angiography (DSA) was performed and the type of AT was evaluated according to Numano classification.
Results: There were 10 women with an average age of 32.4 ± 10 years. The reasons for the study of these patients were stroke in young patients 4, RVH 3 and AI of upper extremities 3 patients. The main types of TA were I: 50 %, V: 40 %, IV 10 %. The main arterial involvement were the supraaortic trunk and both carotids 80 %, right subclavian 80 %, left subclavian 70 %, left vertebral 40 %, right vertebral 30 %, thoracic aortic 40 %, abdominal aortic 40 %, right renal 40 % and left renal 10 %.
Conclusions: The most frequent clinical manifestations were stroke in young patients, RVH and AI. The AT type I was the most common, followed by V and IV respectively, which explains the clinical manifestations.
References
Numano F, Okawara M, Inomata H, Kobayashi Y. Takayasu´s arteritis. Lancet 2000; 356:1023-5.
Aluquin VP, Albano SA, Chan F, Sandborg C, Pitlick PT, Magnetic Resonance imaging in the diagnosis and follow up of Takayasu´s arteritis in children. Ann rheum Dis 2002;61:526-9.
Sheikhzadeh A, Tettenborn I, Noohi F, Efterkhazadeh M, Schnabel A. Oclusive thromboaortopathy Takayasu disease: clinical and angiographic features and a brief review of literature . Angiology 2002;53:29 40.
Johnston SL, Lock RJ, Gompels MM, Tayakayu arteritis: J Clin Pathol 2002; 55:481-6.
Soto ME, Espinola N, Flores-Suarez LF, Reyes PA.Takayasu arteritis: clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival and prognosis. Clin Exp Rheumatol. 2008; 26(3 Suppl 49):S9-15.
Hall S, Barr W, Lie JT, Stanson AW, Kazmier FJ, Hunder GG. Takayasu arteritis: a study of 32 North American patients. Medicine (Baltimore) 1985;64:89-99.
Kerr G. Takayasu´s arteritis. Curr Opin Rheumatol 1994;6:32-8.
Sharma BK, Jain S. Suri, Numano F. Diagnostic criteria for Takayasu arteritis. Int J Cardiol 1996;54 (suppl): S141-S7.
Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: new classification . Int J. Cadiol 1996;54 (suppl):S155-S163.
Arend WP, Michel BA, Bloch DA, Hunder GG,Calabrese LH, Edworthy SM, et al. The AmericanCollege of Rheumatology 1990 criteria for theclassification of Takayasu arteritis. Arthritis Rheum.1990;33:1129-34.
Chatterjee S, Flamm SD, Tan CD, Rodriguez ER. Clinical diagnosis and management of large vessel vasculitis: Takayasu arteritis. Curr Cardiol Rep. 2014;16:499.
Li-xin Z1, Jun N, Shan G, Bin P, Li-ying C. Neurological manifestations of Takayasu arteritis. Chin Med Sci J. 2011;26:227-30.
Chaudhry MA, Latif F . Takayasu’s arteritis and its role in causing renal artery stenosis. Am J Med Sci. 2013;346:314-8.
Hashimoto A, Iwazu Y, Ando Y, Inoue M, Saito O, Asakura S, Muto S, Yagisawa T, Kusano E. Difficult hemodialysis induction due to subclavian steal syndrome in a patient with Takayasu’s arteritis.Nihon Jinzo Gakkai Shi. 2011;53:1034-40.
Lusic I1, Maskovic J, Jankovic S, Cambj-Sapunar L, Hozo I.Endoluminal stenting for subclavian artery stenosis in Takayasu’s arteritis. Cerebrovasc Dis. 2000;10(1):73-5.
Di Renzo M1, Pasqui AL, Pieragalli D, De Franco V, Bracco S, Venturi C, Bruni F, Puccetti L, Verzuri MS, Auteri A.Takayasu’s arteritis: case report of a patient with recurrent subclavian steal syndrome. Heart Vessels. 2004;19:94-7.
Schmidt WA. Imaging in vasculitis. Best Pract Res Clin Rheumatol. 2013;27:107-18.
Schmidt WA. Role of ultrasound in the understanding and management of vasculitis.Ther Adv Musculoskelet Dis. 2014;6:39-47.
Park MC, Lee SW, Chung NS, Lee SK. Clinical characteristic and outcomes of Takayasu, analysis of 108 patients. Scand J Rheumatol. 2005;34:284-92.
Schmidt J, Kermani TA, Bacani AK, Crowson CS, Cooper LT, Matteson EL, Warrington KJ.Diagnostic features, treatment, and outcomes of Takayasu arteritis in a US cohort of 126 patients.Mayo Clin Proc. 2013;88:822-30.
Nooshin D, Neda P, Shahdokht S, Ali J.Ten-year Investigation of Clinical, Laboratory and Radiologic Manifestations and Complications in Patients with Takayasu’s Arteritis in Three University Hospitals. Malays J Med Sci. 2013;20:44-50.
Bicakcigil M, Aksu K, Kamali S, Ozbalkan Z, Ates A, Karadag O, et al. Takayasu in Turkey. Rheumatology. 2009;27:859-64
Kechaou M, Frigui M, Ben Hmida M, Bahloul Z. Takayasu arteritis in Southern Tunisia a study of 29 patients. Presse Med. 2009;38:1410-4.
Suwanwela N, Piyachon C. Takayasu in Thailand, clinical and imaging. Features Int J Cardiol. 1996; 54(Suppl):S117-34.
Arnaud L, Haroche J, Limal N, Toledano D, Gambotti L, Costedoat Chalumeau N, et al. Takayasu arteritis in France, a single-center retrospective study of 82cases. Medicine (Baltimore). 2010;89:1-7.
Moriwaki R Noda M, Yakijama M, Sharma BK, Numano F. Clinical manifestations of Takaya arteritis in India and Japan: new classification of angiographic findings. Angiology 1997;48:369-79.
Ghannouchi JN, Khalifa M, Rezgui A, Alaoua A, Ben JE, Braham A, et al. Takayasu disease in Central Tunisia, 27 cases. J Mal Vase. 2010;35:4-11.