Abstract TP37: Cervical Vascular Findings and Clinical Correlates in Takayasu Arteritis

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Bree Chancellor ◽  
Gibran Shaikh ◽  
Adam Davis ◽  
Pam Rosenthal ◽  
Koto Ishida
Keyword(s):  
Takayasu Arteritis ◽  
Common Finding ◽  
Wall Thickening ◽  
Collateral Flow ◽  
Conventional Angiography ◽  
Neurologic Symptoms ◽  
Clinical Correlates ◽  
American College Of Rheumatology ◽  
Vessel Stenosis ◽  
Symptom Exacerbation

Though luminal changes in Takayasu arteritis (TA) are well seen with conventional angiography, mural changes can be best seen with CTA. Cervical vasculature is affected in over 75% of patients. Cervical vessel findings on CTA and clinical correlates have not been fully described. Methods: Thirteen patients with TA were identified by ICD-9 diagnosis code at two urban hospitals. Diagnosis was confirmed based on American College of Rheumatology criteria for TA. Results: Of 4 male, 9 female (mean age, 37; 5 Latin Am.; 3 Asian; 3 African; 2 North Am.) patients, 10 (77%) had dedicated cervical imaging (CTA/MRA). Ten had neurologic symptoms; visual (46%); weakness/numbness (31%); syncope/dizziness (23%). Nine (69%) had active disease at time of imaging. Twelve (92%) had cervical vessel lesions; 11 (85%) with wall thickening; 11 with vessel stenosis. On average 3 vessels were affected, most commonly L subclavian (69%), L common carotid (54%). Of the 6 patients (46%) with occlusions, all had collateral flow; in 4, wall enhancement, intimal vessel hyperplasia was seen. Three patients imaged before aorto-carotid bypass grafting had an average of 7 diseased cervical vessels. All had strokes soon after bypass, two ischemic with hemorrhagic conversion, a third with IPH/IVH. Two patients had cerebrovascular symptom exacerbation during menses; one was successfully treated with hysterectomy. Findings on cervical imaging directly changed surgical or medical management in 9 (77%) cases. Conclusion: Cervical vessel involvement is pervasive in TA. Wall thickening, a common finding in early and active TA, is not part of current diagnostic criteria and may warrant inclusion. Given the prevalence of cervical vessel disease and its clinical implications, cervical vascular imaging should be considered in all TA patients, particularly those with neurologic symptoms. Combining chest/cervical CTA into a single protocol may be beneficial.

Abstract WMP55: Vessel Wall Characteristics using High Resolution Magnetic Resonance Imaging in Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Russell Cerejo ◽  
Seby John ◽  
Tariq Hammad ◽  
Emmanuel C. Obusez ◽  
Rula Hajj-ali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Vessel Wall ◽  
Clinical Presentation ◽  
Wall Thickening ◽  
Resonance Imaging ◽  
Cns Vasculitis ◽  
Cerebral Vasoconstriction ◽  
Intracranial Vessel ◽  
Vessel Stenosis

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) and central nervous system (CNS) vasculitis often have similar initial clinical presentation, laboratory findings and imaging features creating a diagnostic dilemma. High-resolution-3-Tesla Magnetic Resonance Imaging with Gadolinium contrast (HR-MRI) is a non-invasive method to look at intracranial vessel wall characteristics. Methods: A retrospective analysis of all patients with a diagnosis of RCVS or CNS vasculitis that underwent HR-MRI at our institution was performed. Inclusion criteria for RCVS were clinical presentation, no aneurysmal subarachnoid hemorrhage, normal cerebrospinal fluid and reversible multifocal intracranial vessel stenosis whereas criteria for CNS vasculitis were cases with positive brain biopsy or typical clinical presentation, course and laboratory markers with rheumatology and stroke neurology agreement in diagnosis. Demographics, clinical presentation, laboratory testing, imaging studies and outcomes were collected. Results: Eleven patients with RCVS [10 (90.9%) females, mean age 45.2] and 8 with CNS vasculitis [6 primary CNS vasculitis, 6 (75%) males, mean age 43.5] were included in the study. No abnormal vessel wall enhancement or thickening was seen in any of the RCVS patients in areas of vessel stenosis. Six (75%) of CNS vasculitis patients had vessel wall thickening or enhancement (p=0.001 for comparison to RCVS) and the remaining 2 patients had HR-MRI performed 6 and 10 years after diagnosis and chronic treatment. All RCVS patients who had follow up HR-MRI demonstrated resolution of the multifocal stenosis. Two out of 4 CNS vasculitis patients with subsequent HR-MRI imaging had decrease in vessel wall thickening and enhancement after immunosuppressive therapy. Conclusion: In acute stages of presentation, HR-MRI may be useful in differentiating RCVS from CNS vasculitis. It may also be useful in following the disease course to look for resolution of intracranial vessel stenosis in RCVS or treatment response in vasculitis. Further studies are needed to confirm the utility of HR-MRI in diagnosis and disease progression in RCVS and vasculitis.

Serial changes of carotid wall thickening on ultrasound in Takayasu arteritis

2017 ◽  
Vol 380 ◽  
pp. 234-235 ◽  
Author(s):  
Naoki Makita ◽  
Tomoyuki Ohara ◽  
Jun Fujinami ◽  
Shinji Akioka ◽  
Toshiki Mizuno
Keyword(s):  
Takayasu Arteritis ◽  
Wall Thickening ◽  
Carotid Wall

Utility of intravascular ultrasound in intracranial and extracranial neurointerventions: experience at University at Buffalo Neurosurgery–Millard Fillmore Gates Circle Hospital

2012 ◽  
Vol 32 (1) ◽  
pp. E6 ◽  
Author(s):  
Peter Kan ◽  
Maxim Mokin ◽  
Adib A. Abla ◽  
Jorge L. Eller ◽  
Travis M. Dumont ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Imaging Modality ◽  
Interventional Cardiology ◽  
Plaque Composition ◽  
Intraluminal Thrombus ◽  
Conventional Angiography ◽  
Cross Sectional ◽  
Case Examples ◽  
Vessel Stenosis ◽  
Wide Range

Intravascular ultrasound (IVUS) generates high-resolution cross-sectional images and sagittal reconstructions of the vessel wall and lumen. As a result, this imaging modality can provide accurate measurements of the degree of vessel stenosis, allow the detection of intraluminal thrombus, and analyze the plaque composition. The IVUS modality is widely used in interventional cardiology, and its use in neurointerventions has gradually increased. With case examples, the authors illustrate the utility of IVUS as an adjunct to conventional angiography for a wide range of intracranial and extracranial neurointerventions.

Overview of imaging in adult- and childhood-onset Takayasu arteritis

2021 ◽  
pp. jrheum.210368
Author(s):  
Florence A. Aeschlimann ◽  
Francesca Raimondi ◽  
Tim Leiner ◽  
Giovanni Donato Aquaro ◽  
David Saadoun ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Organ Damage ◽  
Vascular Imaging ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Childhood Onset ◽  
Conventional Angiography ◽  
Disease Extent ◽  
Positron Emission ◽  
Adults And Children

Takayasu Arteritis is an idiopathic large vessel vasculitis, that affects young adults and children and can lead to ischemia and end-organ damage. Vascular imaging is crucial for diagnosis, assessment of disease extent and management of the disease. In this article, we critically review evidence for the clinical use of the different imaging modalities conventional angiography, magnetic resonance imaging, computed tomography, Doppler ultrasound and 18fluorodeoxyglucose positron emission tomography. We thereby focus on their clinical applicability, challenges and specific use in children.

Influence of neutrophil depletion on myocardial function and flow after reversible ischemia

1989 ◽  
Vol 256 (2) ◽  
pp. H341-H351 ◽  
Author(s):  
P. G. O'Neill ◽  
M. L. Charlat ◽  
L. H. Michael ◽  
R. Roberts ◽  
R. Bolli
Keyword(s):  
Polymorphonuclear Leukocytes ◽  
Coronary Occlusion ◽  
Critical Factor ◽  
Wall Thickening ◽  
Collateral Flow ◽  
Vascular Abnormalities ◽  
Reversible Ischemia ◽  
Neutrophil Depletion ◽  
Mediate Cell

We explored the role of polymorphonuclear leukocytes (PMN) in the genesis of contractile dysfunction (myocardial "stunning") and of vascular abnormalities after reversible ischemia. Open-chest dogs underwent a 15-min coronary occlusion and 4 h of reperfusion (REP); treated animals (n = 16) received intravenous goat antiserum against canine PMN, whereas controls received nonimmune goat serum (n = 10) or saline (n = 15). In treated dogs, the average blood PMN levels were 10% of those in saline controls. During ischemia, collateral flow tended to be higher, and paradoxical systolic wall thinning tended to be less in neutropenic dogs, but despite this, recovery of wall thickening after REP was not enhanced in these animals. Similarly, arrhythmias during ischemia or REP did not differ among the three groups. Four hours after REP, both resting and minimal coronary resistance (the latter assessed by adenosine infusion) were higher in the stunned compared with the nonischemic myocardium; these vascular derangements, however, were similar in all three groups. Thus profound neutropenia failed to attenuate mechanical dysfunction, to reduce arrhythmias, and to prevent vascular abnormalities after a 15-min coronary occlusion. Although previous studies have suggested that neutrophils mediate cell death during prolonged ischemia, the present findings suggest that PMN do not contribute importantly to the damage associated with brief, reversible ischemia. The duration of flow reduction may be a critical factor determining whether PMN exacerbate ischemic injury.

scholarly journals The American College of Rheumatology 1990 criteria for the classification of takayasu arteritis

2010 ◽  
Vol 33 (8) ◽  
pp. 1129-1134 ◽  
Author(s):  
William P. Arend ◽  
Beat A. Michel ◽  
Daniel A. Bloch ◽  
Gene G. Hunder ◽  
Leonard H. Calabrese ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
American College Of Rheumatology

Maternal and Neonatal Outcomes in 89 Patients with Takayasu Arteritis (TA): Comparison Before and After the TA Diagnosis

2015 ◽  
Vol 42 (10) ◽  
pp. 1861-1864 ◽  
Author(s):  
Ana Paula Luppino Assad ◽  
Thiago Ferreira da Silva ◽  
Eloisa Bonfa ◽  
Rosa Maria R. Pereira
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Takayasu Arteritis ◽  
Disease Diagnosis ◽  
Fetal Outcome ◽  
Neonatal Outcomes ◽  
Healthy Controls ◽  
American College Of Rheumatology ◽  
Before And After ◽  
Maternal And Neonatal Outcomes

Objective.To evaluate maternal and neonatal outcomes in patients before and after a diagnosis of Takayasu arteritis (TA).Methods.Patients diagnosed with TA according to the American College of Rheumatology criteria were selected from the Vasculitis Outpatient Clinic of the Rheumatology Division. Healthy female staff members of this hospital of similar age and educational level were selected as the controls. The disease data were obtained from an ongoing electronic database protocol. A standardized questionnaire, emphasizing gestational history, was applied to both groups. The prevalence of fetomaternal complications and disease variables were evaluated between the groups and a statistical analysis was performed.Results.A total of 89 patients with TA (156 pregnancies) and 89 healthy controls (181 pregnancies) were evaluated. There were 75.6% pregnancies that occurred before the TA diagnosis (pre-TA group) and 24.3% after (post-TA group). In the pre-TA group, higher rates of hypertension (HTN; 27.1% vs 3.9%, p < 0.001), low birth weight (16.8% vs 6.5%, p = 0.012), and perinatal mortality (7.9% vs 0.7%, p = 0.003) were observed compared with healthy controls. The frequency of abortions and the average number of children were similar in both groups (p > 0.05). Further comparison of the pre- and post-TA groups revealed similar rates of HTN, abortion, and low birth weight, and higher rates of Cesarean delivery (p = 0.002), prematurity (p < 0.001), and infection (p = 0.045) in the latter group.Conclusion.Our study identified that patients with TA, even before the disease diagnosis, have a worse fetal outcome that is most likely associated with high rates of HTN. TA was identified as an additional differential diagnosis for HTN in pregnancy.

scholarly journals REPORTE DE CASO: ARTERITIS DE TAKAYASU EN ECUADOR

2021 ◽  
Vol 32 (1) ◽  
pp. s23-s24
Author(s):  
Rocío Álvarez ◽  
Diana Ramirez ◽  
Patricia Villacís ◽  
Gabriel Acosta
Keyword(s):  
Takayasu Arteritis ◽  
Combined Therapy ◽  
Immunosuppressive Agents ◽  
High Dose ◽  
Acute Phase Reactants ◽  
First Line Therapy ◽  
American College Of Rheumatology ◽  
Low Incidence ◽  
Large Vessels

Introduction Takayasu's arteritis is a panarteritis, characterized by chronic inflammation, that affects large vessels, especially the Aorta and its main branches. This pathology is extremely rare, has a higher incidence in Japan, presenting low incidence in Latin America. Case description We present the case of a young adult, with no significant medical history, who presents a 3 months of evolution intense headache initially classified as trigeminal neuralgia and cluster headache. Asymmetric pulses and variation in blood pressure between both upper extremities where observed which allowed several presumptive diagnoses to be considered. In the complementary examinations, the patient showed sustained elevation of acute phase reactants. Our patient met four diagnostic criteria of the American College of Rheumatology for Takayasu arteritis and the diagnosis was confirmed by magnetic Angio resonance of the neck, chest and abdomen, where involvement of the entire route of the aorta was observed. In context to treatment, the first-line therapy is high-dose steroids. In patients in whom the suspension of steroids is difficult, combined therapy with immunosuppressive agents is used. In the case of our patient, combined therapy with prednisone and methotrexate was chosen, which presented a favorable evolution. Conclusion Takayasu arteritis is an infrequent vasculitis, however, it is important to make an early diagnosis and treatment in order to improve the prognosis, stop the progression of the disease and improve the quality of life of patients suffering from this pathology.

scholarly journals The eyes see what the mind seeks: a systematic review of abdominal imaging findings in patients with COVID-19

2021 ◽  
pp. 20201220
Author(s):  
Lokesh Agarwal ◽  
Ayushi Agarwal ◽  
Shailesh Advani ◽  
Varidh Katiyar ◽  
Aprajita Chaturvedi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Imaging ◽  
World Health ◽  
Common Finding ◽  
Wall Thickening ◽  
Solid Organ ◽  
Imaging Features ◽  
Imaging Findings ◽  
Gi Symptoms ◽  
Insight Into

Objectives: With the increasing recognition of gastrointestinal (GI) manifestation of coronavirus disease-19 (COVID-19), various abdominal imaging findings are increasingly being noted. We scoped the existing literature on the abdominal imaging findings in COVID-19. Methods: A systematic literature search was performed on PubMed, Embase, Google scholar and World Health Organization COVID-19 database. Results: 35 studies were included in the final descriptive synthesis. Among the studies reporting positive abdominal imaging findings in patients with COVID-19, majority described imaging abnormalities of the GI tract (16 studies), of which bowel wall thickening was most frequently reported. Other findings noted were abdominal imaging manifestations of bowel ischemia with thrombosis of the splanchnic vasculature, and imaging features suggestive of pancreatitis. Imaging findings suggestive of solid organ infarction were reported in nine studies. An association between imaging evidence of hepatic steatosis and COVID-19 was noted in three studies. Incidental lung base findings on abdominal imaging were noted in 18 studies, where patients presented with predominant GI symptoms. The most common finding was bilateral ground glass opacities (90.7%) with predominant multilobar (91.1%) and peripheral (64.4%) distribution. Conclusion: This systematic review provides insight into the abdominal imaging findings in patients with COVID-19. Knowledge of these imaging manifestations will not only help in further research but also will aid in curtailing transmission of the SARS-CoV-2. Further prospective studies are needed to gain better insight into the pathophysiology of these imaging manifestations. Advances in knowledge: This review highlights the abdominal imaging findings in patients with COVID-19, to gain insight into the disease pathophysiology and gear the abdominal radiologist through the pandemic.

Sign in / Sign up

Export Citation Format

Share Document