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Clinical Diagnosis and Management of Large Vessel Vasculitis: Takayasu Arteritis

  • Peripheral Vascular Disease (MH Shishehbor, Section Editor)
  • Published:
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Abstract

Takayasu arteritis (TA) is 1 of the 2 main causes of large vessel vasculitides (LVV), giant cell arteritis being the other. LVV can also develop in various other systemic diseases. In TA, a wide variety of symptoms result from vascular stenoses, occlusions, and dilation. Aneurysms may develop and may occasionally dissect or rupture. Disease activity can sometimes be difficult to assess clinically. Diagnostic modalities also have their shortcomings. Often, acute phase reactants do not accurately detect disease activity. Available vascular imaging modalities may be acceptable in defining vascular anatomy, but are notoriously inaccurate in delineating vascular inflammation. Glucocorticoids remain the cornerstone of therapy in TA, in spite of foreseeable long term side effects. In addition, several steroid-sparing agents are also being used, often based on promising results from small uncontrolled studies. Rarely, endovascular revascularization procedures are necessary. Resection of critical-sized aortic aneurysms and repair of aortic dissections are occasionally warranted as lifesaving procedures. The long term outcome of surgical intervention is often unfavorable and relapses are not uncommon. In addition to TA, other less commonly encountered causes of LVV are also briefly discussed in this review.

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Conflict of Interest

Soumya Chatterjee and Carmela D. Tan declare that they have no conflict of interest. Scott D. Flamm has been a consultant for Bayer Healthcare on the Cardiac Imaging Advisory Board. E. Rene Rodriguez declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Rheumatic and Immunologic Diseases, Orthopedic and Rheumatology Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk A50, Cleveland, OH, 44195, USA

    Soumya Chatterjee

  2. Cardiovascular Imaging Laboratory, Imaging Institute and Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA

    Scott D. Flamm

  3. Cardiovascular Pathology, Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA

    Carmela D. Tan & E. Rene Rodriguez

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  1. Soumya Chatterjee
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  2. Scott D. Flamm
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  3. Carmela D. Tan
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Correspondence to Soumya Chatterjee.

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This article is part of the Topical Collection on Peripheral Vascular Disease

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Chatterjee, S., Flamm, S.D., Tan, C.D. et al. Clinical Diagnosis and Management of Large Vessel Vasculitis: Takayasu Arteritis. Curr Cardiol Rep 16, 499 (2014). https://doi.org/10.1007/s11886-014-0499-y

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