title: Outcome of giant cell arteritis of the arm arteries managed with medical treatment alone: cross-sectional follow-up study.
abstract: OBJECTIVE
  To assess the long-term outcome of GCA of the arm arteries under medical treatment alone.
  
  
  METHODS
  Retrospective cross-sectional study of 34 patients with a diagnosis of GCA involving the arm arteries (i.e. subclavian, axillary and/or brachial arteries). All patients were managed with immunosuppressive treatment and antiplatelet agents and followed clinically and with colour duplex sonography. Characteristics of patients with and without relief of ischaemic upper extremity symptoms during follow-up were compared using Fisher's exact test and the Mann-Whitney U-test.
  
  
  RESULTS
  Sixteen of 34 patients (47.1%) suffered from arm claudication at the time of diagnosis (bilateral symptoms in 8 patients). During a mean follow-up of 21.9 (17.1) months, none of the patients developed new ischaemic symptoms of the upper extremities, and five patients became asymptomatic. Critical limb ischaemia did not occur. Symptom relief was significantly less frequent in patients with symptomatic ischaemia of the right arm vs the left arm and was negatively associated with the presence of anaemia and subclavian artery involvement (all P < 0.05). In 32.4% of patients, the vasculitic wall thickening, as depicted by colour duplex sonography, completely disappeared.
  
  
  CONCLUSIONS
  With medical treatment alone, the prognosis of GCA of the arm arteries is benign. Patients with unilateral left-sided ischaemic symptoms may have a higher probability of complete symptom relief than patients with right-sided or bilateral arm claudication.
authors.affiliation: Division of Vascular Medicine, Medical Clinic and Policlinic IV, University Hospital Munich, Pettenkoferstrasse 8a, D-80336 Munich, Germany. michael.czihal@med.uni-muenchen.de
authors.forename: Michael
authors.initials: M
authors.lastname: Czihal
authors.forename: Anne
authors.initials: A
authors.lastname: Piller
authors.forename: Angelika
authors.initials: A
authors.lastname: Schroettle
authors.forename: Peter J
authors.initials: PJ
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; D001132:Arm / Q000098:blood supply; D001366:Axillary Artery / Q000000981:diagnostic imaging; D001916:Brachial Artery / Q000000981:diagnostic imaging; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors