Background In a previous study, computed tomography angiography (CTA) disclosed signs of large-vessel vasculitis (LVV) in 67.5% of giant cell arteritis (GCA) patients at the time of diagnosis. Moreover, 15% of patients already had aortic dilation at that assessment.
Objectives To prospectively evaluate the outcome of large-vessel involvement in GCA patients by comparing CTA findings at the time of diagnosis and those obtained after 1 year of GC treatment.
Methods The 40 GCA-patients evaluated by CTA at diagnosis, were prospectively treated and followed, and scheduled a new CTA after approximately 1 year of treatment GC with homogeneous tapering schedule. Vessel wall thickening, contrast enhancement and vessel diameter at aorta and its tributaries were evaluated. Results were compared to those obtained at the time of GCA diagnosis.
Results Follow-up CTA could be performed in 35 patients after a mean of 13.8 months (range from 12,5 to 24 months) of follow-up. Wall thickening suggesting LVV was still present in 17 patients (68% of the patients who initially had LVV). The number of affected segments and mean wall thickening significantly decreased with no patients developing new inflammatory lesions, new aortic dilation or increase in previous dilations. Moreover, contrast enhancement disappeared in almost all the patients (93.75% of 16 patients where this finding could be assessed).
Conclusions After 1 year of GC treatment, CTA signs of LVV persisted in two thirds of patients who initially presented abnormal findings. However, wall thickening significantly decreased as well as the number of affected segments. Contrast enhancement practically disappeared and there were no changes in lumen diameters during this period of time. Longer follow-up would be necessary to determine clinical significance of these findings and their relationship with the development of aortic dilatation. Supported by SAF 11/30073.
Disclosure of Interest None declared