Cerebrovascular events in Takayasu arteritis: a multicenter case-controlled study
- 315 Downloads
Takayasu arteritis (TA) is a giant cell arteritis usually affecting young women and characterized by inflammatory and ischemic signs of large vessel involvement, including extracranial cerebral arteries. The impact of stroke on TA prognosis has not been well evaluated.
We performed a retrospective multicenter review of patients with definite TA who experienced at least one stroke and compared the findings to 17 matched patients with TA diagnosis without neurological involvement.
Seventeen patients (15 women, median age at stroke diagnosis 44 years) receiving a diagnosis of TA and stroke between 2002 and 2016 in our institution were included, from a cohort of 126 patients suffering from TA (13.5%). At diagnosis, patients from both groups had comparable cardiovascular risk factors. The first cerebrovascular event was ischemic stroke (n = 15) or transient ischemic attack (n = 2). In eight patients, stroke occurred after the TA diagnosis was made. In four patients, stroke occurred after carotid surgery. At the end of follow-up, 59% of patients had a neurological impairment, 35% had a recurrence of stroke, and 24% suffered from epilepsy.
Stroke is a major cause of disability in TA patients. Internal carotid surgery may be performed with caution because of the risk of stroke after the procedure.
KeywordsTakayasu arteritis Stroke Carotid artery Surgery
All the authors (PC, TC, CR, JH, AL, BH, ZA and FCA) contributed to drafting/revising the manuscript for content and study design as well as analysis and interpretation of the data. TC, PC, CR, BH, and FCA contributed to the acquisition of data. PC and FCA conducted the statistical analysis. ZA and FCA coordinated the study. All the authors approved the final submitted version.
Compliance with ethical standards
Conflicts of interest
The authors declare no conflicts of interest and no disclosures relevant to the manuscript.
This study was performed in compliance with the Helsinki Declaration and its later amendments.
For this type of study, formal consent was not required.
This work was not supported by any funding.
- 4.Arnaud L, Haroche J, Limal N, Toledano D, Gambotti L, Costedoat Chalumeau N, Le Thi Huong Boutin D, Cacoub P, Cluzel P, Koskas F, Kieffer E, Piette JC, Amoura Z (2010) Takayasu arteritis in France: a single-center retrospective study of 82 cases comparing white, North African, and black patients. Medicine 89:1–17CrossRefPubMedGoogle Scholar
- 17.Humayun MA, Masood A, Waseem T, Ahmad F, Raza T (2014) An unusual cause of stroke in a young female. Am J Emerg Med 32(685):e683–e685Google Scholar
- 27.Lim AY, Lee GY, Jang SY, Gwag HB, Choi SH, Jeon ES, Cha HS, Sung K, Kim YW, Kim SM, Choe YH, Kim DK (2015) Gender differences in clinical and angiographic findings of patients with Takayasu arteritis. Clin Exp Rheumatol 33:S-132–S-137Google Scholar
- 41.Saadoun D, Lambert M, Mirault T, Resche-Rigon M, Koskas F, Cluzel P, Mignot C, Schoindre Y, Chiche L, Hatron PY, Emmerich J, Cacoub P (2012) Retrospective analysis of surgery versus endovascular intervention in Takayasu arteritis: a multicenter experience. Circulation 125:813–819CrossRefPubMedGoogle Scholar
- 43.Skeik N, Rumery KK, Udayakumar PD, Crandall BM, Warrington KJ, Sullivan TM (2013) Concurrent Takayasu arteritis with common variable immunodeficiency and moyamoya disease. Ann Vasc Surg 27(240):e213–e248Google Scholar
- 45.Srinivas BC, Patra S, Reddy B, Nagesh CM, Manjunath CN (2013) Reocclusion and stroke due to immediate plaque protrusion following endovascular treatment of carotid artery successfully treated with intra-arterial urokinase and stent in stent in a patient with Takayasu arteritis with severe disease of all arch vessels. Cardiovasc Interv Ther 28:394–397CrossRefPubMedGoogle Scholar