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Aortic aneurysms in patients with Takayasu's arteritis: CT evaluation
E Sueyoshi1, I Sakamoto, K Hayashi
1Department of Radiology, Omura Municipal Hospital, Kogashima-chou 133-22, Omura 856-0817, Japan.
Insights
Aortic aneurysms are common in Takayasu
Area of Science:
- Vascular Medicine
- Radiology
- Rheumatology
Background:
- Takayasu's arteritis is a rare inflammatory condition affecting large arteries.
- Aortic involvement is a significant complication, but aneurysm development is not well-characterized.
Purpose of the Study:
- To determine the incidence, progression, and outcomes of aortic aneurysms in patients with Takayasu's arteritis using CT imaging.
Main Methods:
- Retrospective review of 31 Takayasu's arteritis patients diagnosed between 1990-1999.
- Mean follow-up of 52.9 months with serial CT scans.
- Analysis of aneurysm incidence, development, and rupture based on CT findings.
Main Results:
- Aortic aneurysms were found in 45.2% of patients.
- Lower incidence of aneurysms in patients with severe aortic calcification.
- Aneurysms developed or enlarged during follow-up; three rapidly enlarged and ruptured, associated with aortic wall thickening.
Conclusions:
- Aortic aneurysms are a frequent complication of Takayasu's arteritis.
- Aorta with less calcification is more prone to aneurysm formation.
- Aortic aneurysms with wall thickening carry a risk of fatal rupture.
Objective:
The objective of this study was to evaluate the incidence, development, and outcome of aortic aneurysm on CT in a group of patients with Takayasu's arteritis.
Materials And Methods:
We reviewed the files of 31 patients with Takayasu's arteritis between January 1990 and March 1999. All patients were followed up for more than 6 months with CT, and the mean follow-up period was 52.9 months (median, 36.0 months). In all patients, initial CT was performed within 6 months of diagnosis of Takayasu's arteritis. The study group comprised 24 female patients and seven male patients; their ages at the first CT examination ranged from 8 to 72 years (mean, 42. 6 +/- 16.5 years).
Results:
Seventeen aortic aneurysms were found in 14 (45.2%) of the 31 patients. Patients with severe calcification of the aorta showed significantly lower incidence of aneurysm formation than those without severe calcification of the aorta (p < 0.05). Of the 17 aneurysms, three were not present at the time of initial CT and appeared during the follow-up period. Nine of 17 aneurysms increased in size during the follow-up period. Three of the nine aneurysms rapidly increased in size and ruptured during the follow-up period. In all three of these aneurysms, aortic wall thickening was identified on CT. The remaining six aneurysms slowly increased in size but did not rupture.
Conclusion:
Aortic aneurysm associated with Takayasu's arteritis is not rare. The aorta with little calcification has a greater possibility of aneurysm formation in patients with Takayasu's arteritis. Aortic aneurysms with wall thickening can have fatal consequences.