Ultrasound Assessment of Takayasu's Arteritis

Abstract

Introduction

Atherosclerosis is the most common abnormality seen in the vascular laboratory. Rarely, other arterial diseases, such as large vessel vasculitis, are seen. We describe our experience of Takayasu's arteritis (TA).

Methods

The clinical and duplex ultrasound findings of six patients with TA were analyzed. Common sites of involvement and the ultrasound appearances of TA were compared with typical findings of atherosclerosis.

Results

The mean age of the patients was 53 yr, and all were female. TA had been present for 11.8 yr (range, 1–27 yr). All six patients underwent upper extremity duplex scanning. In all cases, abnormalities were present in the proximal and mid common carotid arteries; however, the carotid bifurcation was normal in five of six cases. The proximal subclavian artery was abnormal in five of six cases. In addition, four patients had a severe stenosis in the distal axillary/proximal brachial artery. All of these abnormalities were situated distal to the origin of the subscapular artery. All patients underwent duplex scanning of the abdominal aorta. Severe stenotic disease was present in two patients, with one of these having had a previous aortic grafting procedure. Three additional patients had aortic wall thickening without stenosis. B-mode ultrasonography demonstrated homogenous, concentric, long arterial wall thickening in all areas of abnormality in all cases.

Conclusions

TA is an uncommon disease affecting the large branches of the aorta. The proximal and mid common carotid and the distal axillary arteries are commonly involved, and these sites are unusual in atherosclerosis. The detection of abnormalities on duplex scanning at these sites raises the diagnostic possibility of TA.