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). CONCLUSION: 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.
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). CONCLUSION: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: Christina Duftner; Christian Dejaco; Alexandre Sepriano; Louise Falzon; Wolfgang Andreas Schmidt; Sofia Ramiro Journal: RMD Open Date: 2018-02-02
Authors: Stavros Chrysidis; Christina Duftner; Christian Dejaco; Valentin S Schäfer; Sofia Ramiro; Greta Carrara; Carlo Alberto Scirè; Alojzija Hocevar; Andreas P Diamantopoulos; Annamaria Iagnocco; Chetan Mukhtyar; Cristina Ponte; Esperanza Naredo; Eugenio De Miguel; George A Bruyn; Kenneth J Warrington; Lene Terslev; Marcin Milchert; Maria Antonietta D'Agostino; Mattew J Koster; Naina Rastalsky; Petra Hanova; Pierluigi Macchioni; Tanaz A Kermani; Tove Lorenzen; Uffe Møller Døhn; Ulrich Fredberg; Wolfgang Hartung; Bhaskar Dasgupta; Wolfgang A Schmidt Journal: RMD Open Date: 2018-05-17