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Aneurysms in Takayasu's arteritis: a retrospective study of Chinese patients
Fang Cheng1, Zhuang Shao2, Qing Sheng Lu3
1Department of Rheumatology and Immunology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Aneurysms complicate Takayasu
Area of Science:
- Vascular Medicine
- Rheumatology
- Cardiology
Background:
- Takayasu's arteritis (TAK) can lead to dangerous aneurysms.
- Understanding aneurysm characteristics in TAK is crucial for patient management.
Purpose of the Study:
- To analyze demographic, clinical, and angiographic features of TAK-associated aneurysms.
- To evaluate outcomes in Chinese patients with TAK and aneurysms.
Main Methods:
- Retrospective review of medical charts from 2001-2017.
- Analysis of 397 patients diagnosed with Takayasu's arteritis.
- Comparison of patients with and without aneurysms.
Main Results:
- Aneurysms found in 16.6% of TAK patients.
- Male gender, active inflammation (elevated ESR/CRP), and specific angiographic types (Type V) were more common in aneurysm patients.
- Abdominal aorta was the most frequent aneurysm site.
Conclusions:
- TAK-associated aneurysms present distinct demographic and clinical features.
- Male sex and active vascular inflammation are potential risk factors for aneurysm formation in TAK.
Objectives:
Aneurysm formation can cause life-threatening complications in Takayasu's arteritis (TAK). The objective of this study was to evaluate the demographic, clinical and angiographic features, and outcomes of aneurysm secondary to TAK in Chinese patients.
Methods:
The medical charts of patients diagnosed with TAK in Changhai Hospital between 2001 and 2017 were retrospectively reviewed.
Results:
Aneurysms were identified in 66 (16.6%) of 397 patients with TAK. The mean age at onset was 30.4±11.5 years, with a male:female ratio of 1:2.7. Patients with aneurysm had a higher proportion of male (p<0.01), higher incidences of bruit, chest tightness and aortic regurgitation (all p<0.001), and a lower incidence of visual disturbances (p<0.01) as compared with patients without aneurysm. The prevalence of elevated ESR and CRP and ITAS2010 score were higher in patients with than without aneurysm (all p<0.01). Angiographic classification showed that type V (30.3%) was the most frequent pattern in patients with aneurysm though Type I was dominant in patients without aneurysm. Multiple aneurysms were found in 30.3% of patients and the most common site of aneurysms was abdominal aorta (22.1%). Glucocorticoids were prescribed in 86.4% of patients with aneurysm, and surgical procedures were performed in 80.3%. Five of 52 patients died during the median 3-year follow-up period.
Conclusions:
These findings could provide useful information on the demographical, clinical and angiographic features of TAK patients with aneurysm. Aneurysm formation in TAK may be associated with male gender and active vascular inflammation.
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