Related Experiment Videos
[Involvement of large arteries by Horton's disease]
1Service de médecine interne, Hôpital Foch, Suresnes.
Insights
Temporal arteritis can affect large arteries, particularly the aorta and its branches. Aortic involvement significantly raises the risk of life-threatening complications like aneurysm and dissection.
Area of Science:
- Vascular Medicine
- Rheumatology
- Cardiovascular Pathology
Context:
- Temporal arteritis, a form of large vessel vasculitis, can extend beyond cranial arteries.
- Up to 15% of patients may exhibit large vessel involvement, frequently affecting the aorta and its branches.
Purpose:
- To highlight the prevalence and clinical significance of large vessel involvement in temporal arteritis.
- To differentiate the prognosis of limb versus aortic involvement in this condition.
Summary:
- Large arteries like the ascending aorta, aortic arch, and subclavian/axillary arteries are common sites of temporal arteritis.
- While limb involvement generally responds well to corticosteroids, aortic localization presents a substantially higher risk.
- Aortic involvement can manifest initially or in known cases of temporal arteritis, carrying risks of aneurysm, dissection, and mortality.
Impact:
- Emphasizes the critical need for vigilant monitoring of aortic complications in temporal arteritis patients.
- Informs clinical management strategies, particularly regarding the aggressive nature of aortic involvement.
- Underscores the potentially fatal outcomes associated with untreated or inadequately managed aortic aneurysms and dissections in this vasculitic context.
Abstract:
Up to 15% of patients with temporal arteritis, may have large vessel involvement. The ascending aorta, aortic arch, subclavian and axillary arteries are most frequently involved. These localisations may be the presenting feature but usually, temporal arteritis is known or symptomatic at the time of large vessel involvement discovering. When corticosteroids are given in adequate doses, the response is favorable in most patients with limbs localisation but aortic localisation is associated with a markedly increased risk for the development of aneurysm and dissection which may cause death.