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Balloon angioplasty of arteries of the upper extremities in patients with extracranial giant-cell arteritis
  1. M Both1,
  2. P M Aries2,
  3. S Müller-Hülsbeck1,
  4. T Jahnke1,
  5. P J Schäfer1,
  6. W L Gross2,
  7. M Heller1,
  8. M Reuter1
  1. 1Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
  2. 2Rheumaklinik Bad Bramstedt, Bad Bramstedt, Germany
  1. Correspondence to:
    M Both
    Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany; mboth{at}rad.uni-kiel.de

Abstract

Objectives: To evaluate the outcome of balloon angioplasty in the arteries of the upper extremities in patients with giant-cell arteritis (GCA) and stenosing extracranial involvement.

Methods: Percutaneous transluminal angioplasty (PTA) for symptomatic upper limb artery stenoses (n = 29) and occlusions (n = 1) resistant to medical treatment was carried out in 10 patients (all women, mean age 65 years) with GCA. Vascular lesions were located in the subclavian (n = 4), axillary (n = 10) and brachial (n = 16) arteries. Interventional treatment was accompanied by immunosuppressive drugs in all patients. Follow-up included clinical and serological examination, magnetic resonance angiography and colour duplex ultrasound.

Results: Initial technical success of angioplasty was achieved in the case of all vascular lesions. In five patients, marked recurrent stenoses (vascular territories; n = 10/30) were found during follow-up (mean 24 months). The cumulative primary patency rate was 65.2%. All recurrent lesions developed in the territories of the initial long-segment stenoses. Repeated PTA (vascular territories, n = 8; patients, n = 5) provided a cumulative secondary patency rate of 82.6% and a cumulative tertiary patency rate of 89.7%.

Conclusions: Despite a tendency to restenoses, balloon angioplasty of the upper-extremity artery, in combination with immunosuppressive treatment, is an efficient method for the treatment of extracranial GCA.

  • CRP, C reactive protein
  • DSA, digital subtraction angiography
  • ERS, erythrocyte sedimentation rate
  • GCA, giant-cell arteritis
  • MRA, magnetic resonance angiography
  • PTA, percutaneous transluminal angioplasty

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Footnotes

  • Published Online First 7 February 2006

  • Competing interests: None.

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