Long-Term Outcome and Prognosis of Noninfectious Thoracic Aortitis

Espitia, Olivier; Bruneval, Patrick; Assaraf, Morgane; Pouchot, Jacques; Liozon, Eric; de Boysson, Hubert; Gaudric, Julien; Chiche, Laurent; Achouh, Paul; Roussel, Jean-Christian; Miranda, Sébastien; Mirault, Tristan; Boussouar, Samia; Redheuil, Alban; Serfaty, Jean-Michel; Bénichou, Antoine; Agard, Christian; Guédon, Alexis F.; Cacoub, Patrice; Paraf, François; Fouret, Pierre-Jean; Toquet, Claire; Biard, Lucie; Saadoun, David

doi:10.1016/j.jacc.2023.06.031

Cited by 9 publications

(1 citation statement)

References 42 publications

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“…The prognosis is uncertain, with relapses and possible complications. Stroke, aortic dissection/rupture, myocardial infarction, severe pulmonary hypertension, the side effects of immunosuppressive therapy, cancers, and infections are common complications [ 20 , 21 ]. Biologic therapy and real improvement in long-term outcomes of TA represent a gap in the research.…”

Section: Introductionmentioning

confidence: 99%

Takayasu’s Arteritis: A Special Case Report and Review of the Literature

Moisii,

Jari,

Naum

et al. 2024

Medicina

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Background: Takayasu’s arteritis is a rare type of vasculitis with severe complications like stroke, ischemic heart disease, pulmonary hypertension, secondary hypertension, and aneurysms. Diagnosis is achieved using clinical and angiographic criteria. Treatment is medical and surgical, but unfortunately, the outcome is limited. Case presentation: A 34-year-old Caucasian woman had an ischemic stroke (2009). She was diagnosed with Takayasu’s arteritis and received treatment with methotrexate, prednisolone, and antiplatelet agents, with a mild improvement in clinical state. After 6 years (2015), she experienced an ascending aorta aneurysm, pulmonary hypertension, and mild aortic regurgitation. Surgical treatment solved both the ascending aorta aneurysm and left carotid artery stenosis (ultrasound in 2009 and computed tomography angiogram in 2014). Morphopathology revealed a typical case of Takayasu’s arteritis. Tumor necrosis factor inhibitors (TNF inhibitors) were prescribed with methotrexate. At 48 years old (2023), she developed coronary heart disease (angina, electrocardiogram); echocardiography revealed severe pulmonary hypertension, and angiography revealed normal coronary arteries, abdominal aorta pseudoaneurysm, and arterial–venous fistula originating in the right coronary artery with drainage in the medium pulmonary artery. The patient refused surgical/interventional treatment. She again received TNF inhibitors, methotrexate, antiplatelet agents, and statins. Conclusions: This case report presented a severe form of Takayasu’s arteritis. Our patient had multiple arterial complications, as previously mentioned. She received immunosuppressive treatment, medication targeted to coronary heart disease, and surgical therapy.

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Section: Introductionmentioning

confidence: 99%

Takayasu’s Arteritis: A Special Case Report and Review of the Literature

Moisii,

Jari,

Naum

et al. 2024

Medicina

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Angiologische Diagnostik und Behandlungsmöglichkeiten für entzündliche Gefäßerkrankungen

Jud

2024

rheuma plus

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ZusammenfassungVaskulitiden stellen seltene entzündliche Gefäßerkrankungen meist autoimmuner Genese dar. In den letzten Jahren wurden zu einigen Vaskulitiden neue Klassifikationskriterien und Therapieleitlinien publiziert, weil in der Diagnostik neue Modalitäten und in der Behandlung neue Medikamente zur Anwendung kommen. Ebenso gibt es zunehmende Erkenntnisse über kardiovaskuläre Folgekomplikationen bei Patienten/-innen mit Vaskulitiden. Bei Großgefäßvaskulitiden, wie der Riesenzellarteriitis und der Takayasu-Arteriitis, werden zunehmend radiologische Untersuchungen zur Diagnostik eingesetzt, während in der Abklärung von Kleingefäßvaskulitiden weiterhin Laborparameter und Biopsien einen wichtigen Stellenwert besitzen. Die Therapie von Vaskulitiden umfasst gegenwärtig vor allem den Einsatz diverser immunsuppressiver Medikamente, jedoch können auch Revaskularisationsmaßnahmen großer und mittelgroßer Gefäße notwendig sein. Auch sollten begleitende kardiovaskuläre Risikofaktoren der Patienten/-innen adäquat behandelt werden.

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