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Aortitis and aortic aneurysm in systemic vasculitis

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Abstract

The term “large-vessel vasculitis” refers to chronic inflammation affecting the elastic arteries, mainly aorta and its major branches. Large-vessel vasculitis affecting the aorta is termed as “aortitis.” This leads to diffuse wall thickening, loss of elasticity, stenosis, occlusion, dissection, calcification or aneurysm formation. Vasculitis involving the aorta includes Takayasu arteritis (commonest large-vessel vasculitis in India), giant cell arteritis (GCA), the periaortitis spectrum (including inflammatory abdominal aortic aneurysm), rheumatic diseases and IgG4-related disease. It is important for physicians to be aware of the aortic manifestations of common vasculitis—so that clinically relevant aortic involvement is not missed. Also, it is equally important for surgeons to keep in mind that aortic aneurysms can have an inflammatory aetiology. The primary reason for this is the central role that immunosuppressive therapy plays in the management of inflammatory aortic aneurysms. Surgical or percutaneous interventions, when needed, are most likely to succeed when performed after activity control; perioperative steroids may be beneficial in select cases, and postoperative disease activity control is imperative.

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Acknowledgments

The authors thank Dr. Vaideeswar P and Dr. Deshpande J R for permission to use Figs. 1 and 2 from their article in Vaideeswar and Deshpande [8].

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Authors and Affiliations

  1. Department Cardiology, Govind Ballabh Pant Hospital, Jawaharlal Nehru Marg, New Delhi, Delhi, 110002, India

    Sanjay Tyagi & Safal Safal

  2. Department Radiology, Govind Ballabh Pant Hospital, Jawaharlal Nehru Marg, New Delhi, Delhi, 110002, India

    Dhruv Tyagi

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  1. Sanjay Tyagi
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Correspondence to Sanjay Tyagi.

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Tyagi, S., Safal, S. & Tyagi, D. Aortitis and aortic aneurysm in systemic vasculitis. Indian J Thorac Cardiovasc Surg 35 (Suppl 2), 47–56 (2019). https://doi.org/10.1007/s12055-019-00832-z

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