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Rheumatology Advance Access originally published online on October 13, 2006
Rheumatology 2007 46(1):6-15; doi:10.1093/rheumatology/kel323
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

REVIEWS

Takayasu's arteritis—recent advances in imaging offer promise

J. Andrews and J. C. Mason1

Consultant Rheumatologist, Northwick Park Hospital and Honorary Senior Lecturer, Imperial College London and 1Reader, Imperial College London and Honorary Consultant Rheumatologist, Hammersmith Hospital, London, UK.

Correspondence to: Dr Justin Mason, PhD, FRCP, Eric Bywaters Centre, Cardiovascular Medicine Unit, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK. E-mail: justin.mason{at}imperial.ac.uk


  Abstract

Takayasu's arteritis (TA), a rare large vessel vasculitis of unknown aetiology, remains a difficult disease to manage with diagnosis often delayed until the late occlusive stage when irreversible vascular damage has occurred. Recent studies suggest that non-invasive imaging modalities including magnetic resonance imaging, ultrasound and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) allow diagnosis of TA earlier in the disease course than standard angiography and provide a means for monitoring disease activity. Choice of appropriate therapy for TA is limited by a lack of evidence and a combination of corticosteroids and immunosuppressive drugs is most commonly used. Novel therapeutic approaches such as the use of anti-tumour necrosis factor {alpha} (TNF-{alpha}) inhibitors and drug-eluting arterial stents show promise for improving the prognosis in severe disease. In addition, strict management of traditional cardiovascular risk factors such as dyslipidaemia, hypertension and lifestyle factors is mandatory to minimize secondary cardiovascular complications, which are the major cause of death in this disease.

KEY WORDS: Takayasu's arteritis, Vasculitis, Disease activity, Non-invasive imaging


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