title: Large vessel involvement in biopsy-proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography.
abstract: BACKGROUND
  Necroscopic and surgical studies have suggested that giant cell arteritis (GCA) may target the aorta and its main branches. Imaging techniques are able to detect large vessel vasculitis (LVV) non-invasively in patients, but the prevalence of LVV in GCA has not been clearly established.
  
  
  OBJECTIVE
  To assess prospectively the prevalence, characteristics and topography of LVV in patients with newly diagnosed GCA and to determine the associated clinical and laboratory features.
  
  
  METHODS
  CT angiography (CTA) was performed in 40 consecutive patients with newly diagnosed biopsy-proven GCA. Patients were treatment-naïve or had been treated with corticosteroids for <3 days. Vessel wall thickness and vessel diameter (dilation or stenoses) at four aortic segments (ascending aorta, aortic arch, descending thoracic and abdominal aorta) and at the main aortic branches were evaluated.
  
  
  RESULTS
  LVV was detected in 27 patients (67.5%). The vessels involved were as follows: aorta (26 patients, 65%), brachiocephalic trunk (19 patients, 47.5%), carotid arteries (14 patients, 35%), subclavian arteries (17 patients, 42.5%), axillary arteries (7 patients, 17.5%), splanchnic arteries (9 patients, 22.5%), renal arteries (3 patients, 7.5%), iliac arteries (6 patients, 15%) and femoral arteries (11 patients, 30%). Dilation of the thoracic aorta was already present in 6 patients (15%). Cranial ischaemic events were significantly less frequent in patients with LVV (p=0.029). Treatment-naïve patients had a higher frequency of LVV (77% vs 29%, p=0.005).
  
  
  CONCLUSIONS
  CTA-defined LVV occurs in two-thirds of patients with GCA at the time of diagnosis and aortic dilation is already present in 15%. Previous corticosteroid treatment may decrease CTA-detected LVV.
authors.affiliation: Department of Systemic Autoimmune Diseases, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Prieto-González
authors.forename: Pedro
authors.initials: P
authors.lastname: Arguis
authors.forename: Ana
authors.initials: A
authors.lastname: García-Martínez
authors.forename: Georgina
authors.initials: G
authors.lastname: Espígol-Frigolé
authors.forename: Itziar
authors.initials: I
authors.lastname: Tavera-Bahillo
authors.forename: Montserrat
authors.initials: M
authors.lastname: Butjosa
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sánchez
authors.forename: José
authors.initials: J
authors.lastname: Hernández-Rodríguez
authors.forename: Josep M
authors.initials: JM
authors.lastname: Grau
authors.forename: Maria C
authors.initials: MC
authors.lastname: Cid
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology*; D001027:Aortography / Q000379:methods*; D004108:Dilatation, Pathologic; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*