Takayasu Arteritis – ABC CARDIOL

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Original Article

Prognostic Value of the Hata Angiographic Classification for Long-Term Outcomes in Takayasu Arteritis: A Single-Center, Retrospective Study

Anisio Uchoa Leite Santana et al. Samuel Katsuyuki Shinjo

Abstract

Background

The prognostic utility of the Hata angiographic classification for long-term outcomes in Takayasu arteritis (TAK) remains unclear.

Objectives

To evaluate the prognostic value of the Hata classification for predicting major adverse cardiovascular events (MACE) and the need for vascular interventions in patients with TAK.

Methods

This single-center, retrospective cohort study included patients diagnosed with TAK between 2000 and 2025. Multivariate logistic regression analyses were performed to identify independent predictors, with statistical significance defined as p < 0.05.

Results

Of 203 patients initially identified, 18 were excluded. The final cohort included 185 patients, of whom 80.0% were women, with a median age at diagnosis of 29 years. Type V was the predominant angiographic pattern (64.9%). During a median follow-up of 10.8 years, MACE occurred in 35.7% of patients, while 37.3% required vascular intervention. The Hata classification was not associated with MACE occurrence. Independent predictors of MACE included female sex, which was protective (odds ratio [OR], 0.38; 95% CI, 0.17-0.86; p = 0.021), and longer symptom onset-to-diagnosis time, which increased risk (OR, 1.10; 95% CI, 1.03-1.18; p = 0.006). In contrast, the Hata classification independently predicted the need for vascular intervention. Hata Type I showed a strong protective association compared with Type V (OR, 0.10; 95% CI, 0.01-0.53; p = 0.029). Baseline aortic insufficiency was also independently associated with a higher likelihood of intervention (OR, 2.54; 95% CI, 1.18-5.60; p = 0.018) ().

Conclusions

The Hata classification appears to be a robust predictor of vascular intervention but not MACE in TAK. Greater anatomical disease extension (Type V) and baseline aortic insufficiency were associated with increased procedural risk, whereas MACE risk was associated with diagnostic delay and male sex. The observed long-term dissociation between high rates of clinical remission (92.4%) and continued disease progression underscores the importance of imaging-based surveillance and highlights the need for prospective multicenter studies to validate these findings.

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ABCIC

Review Article

Neurological Manifestations of Takayasu Arteritis: A Case Report and Literature Review

Amanda Antunes Arantes Rolim et al. Tainá Cândida de Almeida Gontijo Carneiro Flávia de Campos Dilson Palhares Ferreira

Abstract

Takayasu arteritis (TA) is a rare large-vessel vasculitis that primarily involves the aorta and its major branches and predominantly affects women of reproductive age. We report the case of a woman who experienced an ischemic stroke at age 20 and a transient ischemic attack at age 53, with TA diagnosed only after the second cerebrovascular event. Although ischemic stroke is an uncommon initial manifestation of TA, early recognition and timely management are essential to prevent further complications and improve long-term outcomes.

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ABC

Original Article

Exploring the Correlations between Initial Clinical and Radiological Manifestations in Takayasu’s Arteritis

Anísio Uchoa Leite Santana et al. Samuel Katsuyuki Shinjo

Abstract

Background

Initial clinical and imaging associations in Takayasu’s arteritis (TAK) are poorly defined.

Objectives

To characterize initial manifestations, their associations, and long-term outcomes in a TAK cohort.

Methods

A single-center retrospective cohort study (2000 to 2024) included patients diagnosed with TAK. The significance level was set at p<0.05.

Results

Among 203 patients identified, 54 were excluded due to incomplete data. The final cohort comprised 149 patients (89.9% female), with a median age at diagnosis of 31 years. At diagnosis, 92.6% were symptomatic. Claudication of upper (36.2%) and lower (30.9%) limbs was frequent, alongside advanced vascular damage like stenosis (85.9%) and occlusions (52.3%). Upper limb claudication was independently predicted by reduced upper limb pulses (OR=4.83; 95%CI=2.08-11.24; p=0.001) and right subclavian artery occlusion (OR=8.06; 95%CI=1.94-33.44; p=0.004). Lower limb claudication was predicted by right subclavian artery occlusion (OR=6.65; 95%CI=2.05-21.61; p=0.002), right subclavian artery thickening (OR=5.12; 95%CI=1.18-22.71; p=0.029), and left subclavian artery stenosis (OR=2.71; 95%CI=1.21-60.56; p=0.016). Over a median 10-year follow-up, despite 91.3% remission, cardiovascular comorbidities increased, and 26.8% required surgery.

Conclusions

Limb claudication is a key prognostic indicator of advanced radiological damage and diagnostic delay. This is reinforced by a long-term dissociation between high clinical remission and progressive vascular disease, demanding vigilant monitoring.

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ABCIC

Case Report

Takayasu’s Arteritis: Ascending Aortic Aneurysm and Coronary Artery Disease in a 19-year-old Young Adult

Iuri Betuel Gomes António et al. Adnaldo da Silveira Maia Janayna Rabelato Aloysio Abdo Silva Campos … Marilia Prudente Menezes Mário Issa

Abstract

Takayasu’s Arteritis (TA) is a disease of multiple presentation, which can involve many different systems and mainly affects women in the first decades of life. The present case reports on a 19-year-old patient with TA, with a diagnosis of ascending aortic aneurysm and severe coronary artery disease in the right coronary artery (RCA) and left coronary trunk (LCT), who underwent an implant of a supracoronary Dacron graft in the ascending aorta and myocardial revascularization with a double internal thoracic artery. The patient evolved satisfactorily in post-op and is today undergoing clinical follow-up in our medical services.

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ABC

Editorial

Takayasu’s Arteritis: Is Age a Differential Factor in the Diagnosis, Follow-Up, and Treatment of the Disease?

Fernanda Luciano Rodrigues

Takayasu’s arteritis (TAK) is a large-vessel inflammatory vasculitis, mainly affecting the aorta, its main divisional branches, and pulmonary arteries, being classically presenting in females aged 20 to 40 years.^–TAK often presents with nonspecific symptoms such as fever, fatigue, abdominal pain, and weight-loss.^,

TAK is a difficult condition to deal with. Early identification of this disease is difficult and necessitates clinical suspicion and vigilance. Radiologic methods can identify diseased vessels but fail to distinguish between active and chronic lesions.Systemic vasculitis can lead to irreversible scars in affected organs, which may be caused by disease activity and/or therapeutic approaches such as corticosteroids and other immunosuppressives.Glucocorticoids remain the most effective and serve as a cornerstone first-line treatment.

[…]

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Unusual Presentation of Takayasu’s Disease

Marta Fontes Oliveira et al. Inês Antunes Fátima Neves Elisabete Pinelo Raquel Faria

Unusual presentation of Takayasu’s disease

A 21-year-old woman was admitted with heart failure and chest pain. Echocardiography revealed a tricuspid aortic valve with severe regurgitation (A), a thickened and deformed right coronary cusp with a linear image (B), and severe left ventricular dilation. Angio-computed tomography showed continuous and concentric thickening of the aortic wall (C) with a penetrating ulcer and dissection of the descending aorta (D) and superior mesenteric and left renal arterial occlusion (E). Takayasu aortitis type V was assumed for which immunosuppression was commenced. Significant improvement was noted (F). After achieving remission, the patient underwent endovascular surgery of the aorta and aortic valve replacement. No episodes of relapses were seen during a 3-year follow-up period.

[…]

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IJCS

Case Report

Takayasu Arteritis as a Secondary Cause of Arterial Hypertension

Pedro Manuel Oliveira et al. Paula Fereira Fábio Murteira Inês Rueff Rato Marta Barbedo

Abstract

Takayasu arteritis (TA) is a rare type of vasculitis that affects mainly the aorta and its major branches. It is highly similar to giant cell arteritis (GCA), and differentiation between them may not be achieved even by histological examination. Arterial hypertension is typical of TA and is caused by stenosis of the renal arteries. Here we report the case of a 59-year-old woman, with a history of dyslipidemia and anemia, seen in the Internal Medicine department for resistant hypertension. Evaluation of secondary causes led to stenosis of the renal arteries. Assessment of target organ involvement was performed by computed tomography angiograph which revealed ectasia of the aortic arch and ascending aorta, tortuous course of the brachiocephalic trunk and the proximal portion of the right common carotid artery; positron-emission tomography which showed diffuse increased uptake in the ascending aorta, compatible with large vessels vasculitis. The patient was submitted to aortic valve replacement with a biological prosthesis combined with myocardial revascularization (Bentall-De Bono procedure). Aortic biopsy specimens showed anatomical and pathological features of GCA and TA. Due to persistently uncontrolled hypertension, prednisone 60 mg was initiated,with significant improvement in patient’s condition.

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IJCS

Case Report

Surgical Repair of a Ruptured Giant Abdominal Aortic Aneurysm in a 16-Year-Old with Takayasu’s Arteritis: Case Report and Etiological Review

José Maciel Caldas dos Reis et al. Glauco dos Santos Melo Murilo Vasconcelos de Oliveira Felipe Eduardo de Oliveira Santos … Tereza Maria Meireles Fernandes da Silva Hugo Luis da Silva Ferreira

Abstract

Takayasu’s arteritis is a type of primary systemic vasculitis that affects medium and large arteries, including the aorta and its main branches, as well as the pulmonary and coronary arteries. Although rare in children, it is the third most common vasculitis in the pediatric population, often with delayed diagnosis due to the nonspecific presentation of clinical symptoms in its initial phase. This is a case of a 16-year-old girl with a giant ruptured abdominal aortic aneurysm, who needed surgery on an emergency basis. The etiological aspects involved in aneurysms in young patients are also addressed.

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Artigo Original

Features of the onset of Takayasu's arteritis acccording to gender

Andrea Rocha de Saboia Mont'Alverne et al. Luiz Eduardo de Paula Samuel Katsuyuki Shinjo

BACKGROUND: Although there are various published epidemiological studies regarding Takayasu’s arteritis (TA), none have analyzed the influence of gender on the clinical and laboratory manifestations or vascular alterations at disease onset. OBJECTIVES: To analyze the influence of gender on clinical and laboratory manifestations and variations in vascular imaging at TA onset. METHODS: A retrospective, unicentric cohort study that evaluated 55 consecutive TA patients between 1982 and 2012. All available clinical data and laboratory test results related to the onset of the disease were analyzed. We included only patients aged 12-35 years at diagnosis to exclude age-related factors. RESULTS: We analyzed 17 men and 38 women, mostly Caucasian, with a comparable mean age between genders. There was no gender difference regarding the clinical or laboratory characteristics, comorbidities, or smoking habit, except for abdominal pain, which was more common in men. Regarding vascular lesions, the presence of ascending aortic aneurysms was significantly more frequent in males. Male gender represented an independent risk factor for the occurrence of abdominal pain and ascending aortic aneurysms in TA patients. CONCLUSION: Abdominal pain and ascending aortic aneurysms occurred more frequently in men with TA, suggesting a more severe disease profile in males.

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Case Report

Pregnancy follow-up and outcome in a patient with Takayasu's arteritis

Alexandre Jorge Gomes de Lucena et al. Antonio Carlos Carvalho Jose Augusto M. Souza Antonio Fernandes Moron … Sue Y. Sun Daniel Born

We describe here the pregnancy follow-up and outcome in a patient with Takayasu’s arteritis, with a detailed account of the complications during gestation and delivery and the impact of the disease on the newborn’s health.

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