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Implicación de la arteria carótida interna y riesgo de ictus en la arteritis de Takayasu: un estudio de casos y

Hulya Odabasi Bukun¹, Ugur Uygunoglu², Esra Firat Senturk³

¹Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.

Rheumatology international

|February 7, 2026

Resumen

El ictus es una complicación importante en la arteritis de Takayasu (AT). Los pacientes varones y aquellos con afectación de la arteria carótida interna (ACI) corren el mayor riesgo, con consecuencias devastadoras a largo plazo que incluyen discapacidad y mortalidad.

Área de la Ciencia:

Neurología Vascular; Reumatología; Inmunología

Sus antecedentes:

El ictus es una complicación importante de la arteritis de Takayasu (AT), una enfermedad inflamatoria rara que afecta a las arterias grandes.
Comprender las características clínicas y los resultados del ictus en pacientes con AT es crucial para mejorar el manejo.

Objetivo del estudio:

Determinar las características clínicas y los resultados neurológicos de los pacientes con AT e ictus en comparación con los que no lo tuvieron.
Identificar los predictores de ictus en pacientes con AT.

Principales métodos:

Análisis retrospectivo de 35 pacientes con AT e ictus y 50 pacientes con AT sin ictus.
Evaluación de datos demográficos, manifestaciones clínicas, afectación arterial, tratamientos y resultados neurológicos (utilizando EDSS, Índice de Barthel, Escala de Rankin Modificada).

Principales resultados:

Los pacientes con ictus tuvieron más probabilidades de ser varones (22,9 % frente a 6,0 %) y presentaron una afectación significativamente mayor de la arteria carótida interna (ACI) (ACI derecha: 51,4 % frente a 18,0 %; ACI izquierda: 37,1 % frente a 18,0 %).
El sexo masculino (OR=5,70) y la afectación de la ACI (OR=5,98) fueron predictores independientes de ictus.
El ictus se produjo como manifestación inicial de la AT en el 40 % de los casos, y el 85,7 % de los pacientes con ictus ya estaban en tratamiento inmunosupresor.
Los pacientes con ictus experimentaron una discapacidad significativa (EDSS medio: 3,63) y una mortalidad del 11,4 % en 5 años.

Conclusiones:

El sexo masculino y la afectación de la ACI son factores de riesgo clave para el ictus en la AT.
Las estrategias de manejo actuales, incluida la inmunosupresión, parecen inadecuadas para prevenir el ictus en pacientes con AT.
El ictus asociado a la AT provoca discapacidad grave, aumento de la mortalidad y altas tasas de recurrencia, lo que requiere la mejora de los enfoques terapéuticos.

Palabras clave:

Estenosis carotídea Trastornos cerebrovasculares Ictus Arteritis de Takayasu Vasculitis

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