Balloon angioplasty of arteries of the upper extremities in patients with extracranial giant-cell arteritis.
OBJECTIVE
To evaluate the outcome of balloon angioplasty in the arteries of the upper extremities in patients with giant-cell arteritis (GCA) and stenosing extracranial involvement.


METHODS
Percutaneous transluminal angioplasty (PTA) for symptomatic upper limb artery stenoses (n = 29) and occlusions (n = 1) resistant to medical treatment was carried out in 10 patients (all women, mean age 65 years) with GCA. Vascular lesions were located in the subclavian (n = 4), axillary (n = 10) and brachial (n = 16) arteries. Interventional treatment was accompanied by immunosuppressive drugs in all patients. Follow-up included clinical and serological examination, magnetic resonance angiography and colour duplex ultrasound.


RESULTS
Initial technical success of angioplasty was achieved in the case of all vascular lesions. In five patients, marked recurrent stenoses (vascular territories; n = 10/30) were found during follow-up (mean 24 months). The cumulative primary patency rate was 65.2%. All recurrent lesions developed in the territories of the initial long-segment stenoses. Repeated PTA (vascular territories, n = 8; patients, n = 5) provided a cumulative secondary patency rate of 82.6% and a cumulative tertiary patency rate of 89.7%.


CONCLUSIONS
Despite a tendency to restenoses, balloon angioplasty of the upper-extremity artery, in combination with immunosuppressive treatment, is an efficient method for the treatment of extracranial GCA.
Both
M
M
Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany. mboth@rad.uni-kiel.de
Aries
P M
PM
Müller-Hülsbeck
S
S
Jahnke
T
T
Schäfer
P J
PJ
Gross
W L
WL
Heller
M
M
Reuter
M
M
D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D013700:Giant Cell Arteritis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency
D007166:Immunosuppressive Agents