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Endovascular treatment of critical lower limb ischemia caused by giant cell arteritis
Rohan H P McLachlan1,2, Andrew F Lennox1,3, Ramon L Varcoe1,2,3
1Department of Vascular Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Insights
Giant cell arteritis (GCA), a vasculitis, can cause critical lower limb ischemia. Endovascular treatment, like stenting, offers a safe and feasible option for limb salvage in GCA patients.
Area of Science:
- Vascular Medicine
- Rheumatology
- Interventional Cardiology
Background:
- Giant cell arteritis (GCA) typically affects cranial arteries, causing symptoms like headache and jaw claudication.
- Lower limb ischemia is an uncommon presentation of GCA, often overlooked in the absence of atherosclerosis.
- Prompt diagnosis and management are crucial to prevent severe complications such as critical limb ischemia.
Abstract:
Giant cell arteritis (GCA) is a well-known cause of cranial vasculitis often presenting with headache and jaw claudication. Here we report the case of a woman suffering GCA who presented with critical lower limb ischemia. Despite best medical therapy, she developed progressive calf claudication and ulceration of the right foot. The findings on workup were highly suggestive of GCA involving the superficial femoral artery. The limb was successfully revascularized with angioplasty and placement of a drug-eluting stent. GCA is an important cause of lower limb ischemia and should be considered in patients without evidence of atherosclerosis. Endovascular intervention is a feasible treatment of critical limb ischemia due to GCA and has been shown to be safe in this case.
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