A Case Study of Takayasu's Arteritis of Carotid Arteries: A Distinct Role for Sonography in Monitoring Disease Status and Follow-up Care

Abstract

Takayasu's Arteritis (TA) is a rare chronic inflammatory disease characterized as a large-sized vessel vasculitis involving all layers of the arterial wall. In this case report, we describe a 51-year-old Persian woman with a history of TA who had occlusion of the left common carotid artery (CCA) that was successfully treated by left CCA stenting. Carotid duplex ultrasound was performed by the use of B-mode imaging with pulsed Doppler to evaluate the common carotid arteries, internal carotid arteries, external carotid arteries (ECA), and vertebral and subclavian arteries. Ultrasound revealed total occlusion of the left CCA, retrograde blood flow in the left ECA maintaining antegrade flow into the internal carotid artery, and markedly elevated velocities in the right vertebral and subclavian arteries. After stent replacement, ultrasound revealed blood flow in the left CCA, antegrade flow in the left ECA, and decreased velocities in the right vertebral and subclavian arteries. In conclusion, sonography as a noninvasive imaging modality distinctly detects and confirms vascular lesions and progressive changes in the arterial walls. Above all, this method can be used to evaluate and measure luminal wall thickening and narrowing, as well as change in the blood flow velocity to safely implement continuation of follow-up care for patients with Takayasu's Arteritis.