Takayasu's arteritis-recent advances in imaging offer promise

Takayasu's arteritis (TA), a rare large vessel vasculitis of unknown aetiology, remains a difficult disease to manage with diagnosis often delayed until the late occlusive stage when irreversible vascular damage has occurred. Recent studies suggest that non-invasive imaging modalities including...

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Bibliographic Details
Published in:Rheumatology (Oxford, England) England), 2007-01, Vol.46 (1), p.6-15
Main Authors: Andrews, J., Mason, J. C.
Format: Article
Language:English
Subjects:
Angiography - methods
Biological and medical sciences
Cardiovascular system
Diseases of the osteoarticular system
Glucocorticoids - therapeutic use
Humans
Immunosuppressive Agents - therapeutic use
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Angiography - methods
Medical sciences
Positron-Emission Tomography - methods
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Takayasu Arteritis - diagnosis
Takayasu Arteritis - therapy
Ultrasonography, Doppler - methods
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Summary:Takayasu's arteritis (TA), a rare large vessel vasculitis of unknown aetiology, remains a difficult disease to manage with diagnosis often delayed until the late occlusive stage when irreversible vascular damage has occurred. Recent studies suggest that non-invasive imaging modalities including magnetic resonance imaging, ultrasound and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) allow diagnosis of TA earlier in the disease course than standard angiography and provide a means for monitoring disease activity. Choice of appropriate therapy for TA is limited by a lack of evidence and a combination of corticosteroids and immunosuppressive drugs is most commonly used. Novel therapeutic approaches such as the use of anti-tumour necrosis factor α (TNF-α) inhibitors and drug-eluting arterial stents show promise for improving the prognosis in severe disease. In addition, strict management of traditional cardiovascular risk factors such as dyslipidaemia, hypertension and lifestyle factors is mandatory to minimize secondary cardiovascular complications, which are the major cause of death in this disease.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/kel323