title: Involvement of the femoropopliteal arteries in giant cell arteritis: clinical and color duplex sonography.
abstract: OBJECTIVE
  To determine the extent and clinical significance of giant cell arteritis (GCA) of the femoropopliteal arteries.
  
  
  METHODS
  This was a retrospective clinical color duplex sonography (CDS) study; 60 of 112 consecutive patients with the diagnosis of GCA underwent complete clinical examination of the lower extremities including the vasculature, systolic ankle pressure measurement, and CDS scans of the femoropopliteal arteries within 1 year after diagnosis of GCA. Circumferential, hypoechogenic, homogenous wall thickening was regarded as a hallmark of femoropopliteal GCA.
  
  
  RESULTS
  GCA of femoropopliteal arteries was present in 32 (53.3%) of 60 patients. In general, femoropopliteal GCA developed bilaterally (100%) and 14 patients (23.3%) had significant lower extremity artery obstructions secondary to vasculitis, all leading to symptomatic lower extremity ischemia, with development of critical leg ischemia in 4 patients. Compared with subjects without lower extremity vasculitis, patients with femoropopliteal involvement had a significant time delay until diagnosis (mean 23.9 vs 11.1 weeks; p = 0.03) and a higher frequency of concomitant vasculitis of the arm arteries (74.2% vs 42.9%; p = 0.02).
  
  
  CONCLUSIONS
  Femoropopliteal artery involvement appears to be a clinically relevant manifestation of GCA, frequently leading to symptomatic lower extremity ischemia. CDS of the femoropopliteal arteries is a noninvasive diagnostic tool for detection of lower extremity vasculitis in GCA.
authors.affiliation: Division of Vascular Medicine, Medical Policlinic, University Hospital, Campus City Center, Munich, Germany. michael.czihal@med.uni-muenchen.de
authors.forename: Michael
authors.initials: M
authors.lastname: Czihal
authors.forename: Federico
authors.initials: F
authors.lastname: Tatò
authors.forename: Antje
authors.initials: A
authors.lastname: Rademacher
authors.forename: Peter
authors.initials: P
authors.lastname: Kuhlencordt
authors.forename: Hendrik
authors.initials: H
authors.lastname: Schulze-Koops
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hoffmann
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color