What is the role of angiography in the diagnosis of Takayasu arteritis?

Updated: Nov 14, 2018
  • Author: Jefferson R Roberts, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Angiography, the criterion standard for the diagnosis and evaluation of Takayasu arteritis, is used to evaluate only the appearance of the lumen and cannot be used to differentiate between active and inactive lesions. (See the images below.) Takayasu arteritis can be divided into the following 6 types based on angiographic involvement: [3]

  • Type I - Branches of the aortic arch

  • Type IIa - Ascending aorta, aortic arch, and its branches

  • Type IIb - Type IIa region plus thoracic descending aorta

  • Type III - Thoracic descending aorta, abdominal aorta, renal arteries, or a combination

  • Type IV - Abdominal aorta, renal arteries, or both

  • Type V - Entire aorta and its branches

    Complete occlusion of the left common carotid arte Complete occlusion of the left common carotid artery in a 48-year-old woman with Takayasu disease. Also note narrowing of the origin of the right subclavian artery and a narrowed small vessel with subsequent aneurysmal dilatation on the right side. Image courtesy of Robert Cirillo, MD.
    Characteristic long, tapered narrowing of the dist Characteristic long, tapered narrowing of the distal aorta and iliac vessels. Image courtesy of Robert Cirillo, MD.
    Image obtained in the same patient as in Image 2 r Image obtained in the same patient as in Image 2 reveals narrowing of the proximal descending aorta and right brachiocephalic artery. Image courtesy of Robert Cirillo, MD.
    Aortogram of a 15-year-old girl with Takayasu arte Aortogram of a 15-year-old girl with Takayasu arteritis. Note large aneurysms of descending aorta and dilatation of innominate artery. Image courtesy of Christine Hom, MD.

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