[Takayasu arteritis: usefulness of radiologic and angiographic studies]

With the purpose of learning the usefulness of radiologic and angiographic procedures for the evaluation of Takayasu's arteritis (TA), we studied 64 patients (ratio women: 8.1, average age: 23.5 years, range: 13-52 years) in which we performed arteriographic studies in the clinically affected area. All cases had chest films: 53 had thoracic aortogram, 60 abdominal aortogram, 16 pulmonary arteriography. According to the topography of the lesions we found 8% of the cases with damage exclusive to the supra-aortic trunk, 6% with isolated alteration of the intermediate thoraco-abdominal aorta, 62% with mixed pathology of the two categories above, and 21% with lesions in the pulmonary artery besides systemic arteriopathy. The results were as follows: 1) radiology of the chest: cardiomegaly (48%), irregularities in the ascending aorta (31%), calcification in the aortic wall (29%), calcified granulomas (25%) and signs of pulmonary venous hypertension (21%); 2) thoracic aortogram: irregularities in the descending aorta (56.6%), thickening of the wall of descending aorta (39.6%), dilatation of the ascending aorta (26.4%), of the descending aorta (26.4%); occlusions: of the left subclavian (24 cases), left mammary (16 cases), left carotid (8 cases) and left vertebral (8 cases); 3) abdominal aortogram: irregularities of the outline, stenosis, prominent "supplementary" arteries and aneurysms in 53%, 43.3%, 38% and 13.3 of the studies performed. The arteries most commonly affected were: renal (74.7%), both (31.6%), right (28.2%) and left (14.9%), superior mesenteric (26.6%) and hepatic (21.6%); 4) pulmonary arteriography: arterial occlusions: right superior lobar branch (37.5%), right medial (6.2%), right inferior (12.5%), without predilection by any lobe; 5) coronary arteriography: one case with occlusion of anterior descending artery and circumflex coronary artery (the other 8 cases without significant lesions). We concluded that TA affects independently the arteries of different areas, hence it is necessary to perform multiple angiographic studies for adequate evaluation of the extension of vascular damage.