Immediate and long-term outcome of upper extremity balloon angioplasty in giant cell arteritis
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Published on: September 8, 2023
Beatrice R Amann-Vesti1, Renate Koppensteiner, Lisa Rainoni
1Department of Internal Medicine, Division of Angiology, University Hospital, Zurich, Switzerland. beatrice.amann@dim.usz.ch
Insights
Balloon angioplasty (PTA) effectively treats upper limb artery blockages in giant cell arteritis (GCA). Long-term success is enhanced with steroid and aspirin therapy.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Rheumatology
Background:
- Giant cell arteritis (GCA) can cause stenosis or occlusion in upper limb arteries, leading to symptoms like claudication.
- Percutaneous transluminal angioplasty (PTA) is a potential treatment for these vascular complications.
Observation:
- This study reviewed four patients with GCA-related upper limb artery disease who underwent PTA.
- Procedures addressed stenoses and occlusions in the subclavian, axillary, and brachial arteries.
- Patients received pre-procedural steroids, continued for at least two years post-intervention.
Findings:
- All PTA procedures were technically successful, with no residual stenosis.
- Duplex scanning at 2, 5, and 10 years showed no significant recurrent stenoses.
- Percutaneous transluminal angioplasty demonstrated immediate and long-term efficacy.
Implications:
- PTA is a safe and effective treatment for GCA-induced upper limb artery stenosis and occlusion.
- Sustained steroid and aspirin therapy appears crucial for favorable long-term outcomes.
- These findings support PTA as a valuable therapeutic option in managing GCA vasculopathy.
Purpose:
To review the immediate and long-term results of subclavian, axillary, and brachial artery balloon angioplasty (PTA) in giant cell arteritis (GCA).
Case Reports:
Four patients (3 men; mean age 65+/-8.9 years) with upper limb claudication due to GCA underwent PTA for 2 stenoses and 1 occlusion of the subclavian artery, 6 stenoses and 2 occlusions of the axillary artery, and 2 stenoses of the brachial artery. Patients received steroids prior to the intervention, and steroid treatment was continued for at least 2 years. All procedures were performed successfully with no residual stenosis. At follow-up after 2 years (n=2), 5 years (n=1), and 10 years (n=1), no significant recurrent stenoses were detected by duplex scanning.
Conclusions:
PTA is a safe and effective therapy for stenotic lesions and occlusions of the upper limb arteries due to GCA. The long-term results seem to benefit from postprocedural therapy with steroids and aspirin.
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