Digital subtraction panaorto-arteriography was performed in 32 consecutive children (21 females, mean age 10.8 years) with non-specific aorto-arteritis to assess digital subtraction angiography (DSA) in imaging these children and to study the patterns of involvement in the Indian sub-continent. Diagnostic quality DSA images were obtained in 21 out of 27 intravenous and nine out of 11 intra-arterial studies. Obstructive lesions were present in all the patients and commonly involved the abdominal aorta (24 patients) and renal arteries (20 patients). Aneurysms were seen in five patients and predominantly involved the descending thoracic aorta. Pulmonary artery involvement was uncommon (five out of 20 patients) and clinically silent. Based on clinical and angiographic features, percutaneous transluminal angioplasty was performed for the management of uncontrolled hypertension in eight patients (10 lesions). Initial success was obtained in eight procedures (80%). Re-stenosis occurred after 5.5 months in one patient, but was successfully re-dilated. The follow-up period ranged between 5 and 16 months (mean 9 months). Long-term efficacy of transluminal angioplasty in the management of these children is awaited.
We compared clinical and angiographic features of nonspecific aorto-arteritis in children with those of adult patients. Digital subtraction angiography by i.v. and/or i.a. injection was carried out in 104 patients. In group 1, consisting of 32 patients aged 16 years and younger, hypertension (75%) was the most common clinical feature, followed by diminished pulse, bruit (72% each), congestive cardiac failure (38%), and limb claudication (1 3%). Obstructing arterial lesions were always present and commonly involved the abdominal aorta (75'%), descending thoracic aorta (41%), renal (63%)) and subclavian (41%) arteries. In Group 2, consisting of 72 patients more than 16 years of age, arterial bruit (91%), and diminished pulse (82%) were the most common symptoms. Hypertension occurred in 61%, congestive failure in 14%, and limb claudication in 30'%. Obstructing lesions were always seen and commonly involved the abdominal aorta (77%) and renal arteries (64%). Involvement of the descending thoracic aorta (26%) was less common but subclavian (57%) and carotid (24%)) arteries were more commonly involved than in group I. Arterial aneurysms and pulmonary involvement were uncommon in both groups. There were some clinical and angiographic differences in nonspecific aorto-arteritis between children and adults but these were statistically insignificant (chisquare test).
We compared clinical and angiographie features of nonspecific aorto-arteritis in children with those of adult patients. Digital sub traction angiography by i.v. and/or i.a. injection was carried out in 104 patients. In group 1, consisting of 32 patients aged 16 years and younger, hypertension (75%) was the most common clinical feature, followed by diminished pulse, bruit (72% each), congestive cardiac failure (38%), and limb claudication (13%). Obstructing arterial lesions were always present and commonly involved the abdominal aorta (75%), descending thoracic aorta (41%), renal (63%) and subclavian (41%)) arteries. In Group 2, consisting of 72 patients more than 16 years of age, arterial bruit (91%>), and dimin ished pulse (82°/)) were the most common symptoms. Hypertension occurred in 61%, congestive failure in 14%, and limb claudication in 30%. Obstructing lesions were always seen and commonly in volved the abdominal aorta (77%) and renal arteries (64%). Involve ment of the descending thoracic aorta (26%) was less common but subclavian (57%) and carotid (24%) arteries were more commonly involved than in group 1. Arterial aneurysms and pulmonary in volvement were uncommon in both groups. There were some clinical and angiographie differences in nonspecific aorto-arteritis between children and adults but these were statistically insignificant (chisquare test).
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