Diagnosis, Management, and Outcome of Aortitis at a Single Center

• Published in: Vascular and endovascular surgery 2017-10, Vol.51 (7), p.470-479
• Main Authors: Skeik, Nedaa, Ostertag-Hill, Claire A., Garberich, Ross F., Alden, Peter B., Alexander, Jason Q., Cragg, Andrew H., Manunga, Jesse M., Stephenson, Elliot J., Titus, Jessica M., Sullivan, Timothy M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Aortitis - diagnostic imaging; Aortitis - epidemiology; Aortitis - therapy; Disease Progression; Endovascular Procedures - adverse effects; Female; Giant Cell Arteritis - diagnostic imaging; Giant Cell Arteritis - epidemiology; Giant Cell Arteritis - therapy; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Male; Middle Aged; Minnesota - epidemiology; Remission Induction; Retrospective Studies; Steroids - adverse effects; Steroids - therapeutic use; Takayasu Arteritis - drug therapy; Takayasu Arteritis - epidemiology; Takayasu Arteritis - therapy; Time Factors; Treatment Outcome
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/1538574417704296

Background: Aortitis is a rare condition with inflammatory or infectious etiology that can be difficult to diagnose due to the highly variable clinical presentation and nonspecific symptoms. However, current literature on the diagnosis, management, and prognosis of aortitis is extremely scarce. Methods: We retrospectively reviewed all patients’ charts who were diagnosed with giant cell arteritis, Takayasu arteritis, or noninfectious aortitis presenting at a single center between January 1, 2009, and April 17, 2015. Data collected included demographics, medical history, comorbidities, laboratory and imaging data, management, and outcome. Results: Among the included 15 patients presenting with aortitis at our center, 53% were diagnosed with Takayasu arteritis, 33% with idiopathic inflammatory aortitis, and 13% with giant cell arteritis. All patients received steroid treatment, 67% received adjunctive immunosuppressants or immunomodulators, and 33% underwent interventional procedures. Based on clinical presentation and laboratory and imaging findings at the last follow-up visit for each patient, 67% showed improvement, 27% had no change in disease activity, and 7% had a progression of the disease. Conclusions: Takayasu arteritis was found to be more common than idiopathic inflammatory aortitis and giant cell arteritis among our 15 cases diagnosed with aortitis. All patients received medical therapy and 33% received interventional procedures, leading to 67% improvement of disease activity or related complications. This article also offers a comprehensive review of the diagnosis, management, and outcome of aortitis, supplementing the very limited literature on this disease.