Carotid sonographic features in Takayasu's arteritis: A case-control study

Takayasu arteritis (TAK) is a rare large-vessel vasculitis that affects the carotid arteries. Increased intima-media thickness (IMT) and atherosclerotic changes are detectable by ultrasonography (US). This study aimed to evaluate detailed carotid sonographic features in TAK and compare them with diabetes mellitus (DM), as well as to assess correlations between sonographic parameters and inflammatory markers.

In this case-control study, 15 patients with TAK fulfilling the 1990 American College of Rheumatology criteria (2012-2022) and 15 patients with DM were evaluated at Loghman Hakim Hospital. Cardiovascular risk factors, carotid ultrasonography, and serum inflammatory markers were assessed. Data were analyzed using univariate and multiple regression tests (SPSS V24).

Atherosclerotic plaques were found in 46.7% of TAK and 53.3% of DM patients. IMT of common (CCA) and internal carotid arteries (ICA) was significantly higher in TAK (p<0.05). The macaroni sign (P=0.001), turbulent flow (P=0.006), and higher CCA resistivity index (RI) (P=0.047) were characteristic of TAK. ESR and CRP correlated with pre-bifurcation CCA mean IMT (p<0.05). Each unit increase in CRP was associated with a 0.02 mm increase in right CCA IMT (P=0.05).

Carotid ultrasonography is a valuable tool in evaluating TAK. Distinguishing features include the presence of the macaroni sign, turbulent flow, and higher IMT and RI. Increased IMT was associated with elevated CRP.