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Rheumatology Advance Access published online on October 13, 2006
Rheumatology, 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
Received July 29, 2006
Accepted August 17, 2006

Review Article

Takayasu's arteritis--recent advances in imaging offer promise

J. Andrews 1 and J. C. Mason 2 *

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

* To whom correspondence should be addressed.
J. C. Mason, 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.

Keywords: Takayasu's arteritis; Vasculitis; Disease activity; Non-invasive imaging.
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