Progress in Gerontology: Polymyalgia Rheumatica and Temporal Arteritis

Goodwin, James S.

doi:10.1111/j.1532-5415.1992.tb02023.x

Cited by 21 publications

(6 citation statements)

References 106 publications

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“…The incidence of giant cell arteritis (GCA) in the US has been reported as high as 27 cases per 100,000 persons over 50 years old. Patients with Northern European ancestry have a higher incidence [1]. The aortic root is involved in 9-18% of cases [2].…”

Section: Discussionmentioning

confidence: 99%

Development of Mega-Aorta Following Incompletely Treated Giant Cell Arteritis

Eton

Shah

Merlo

et al. 2014

aorta

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An 82-year-old male presented with a 9.3 cm ascending aorta and arch aneurysm with additional aneurysms of the innominate, right subclavian, and left common carotid arteries. The patient had a history of temporal arteritis that was only briefly treated in 1989 and a 6 cm ascending aortic aneurysm that was repaired in 1993. Our operative strategy was to construct a temporary parallel cerebrovascular circuit for cerebral protection during the redo-sternotomy and aortic arch reconstruction, with the added benefit of permanently excluding the branch arch vessel aneurysms. Pathological analysis of the aortic specimen at the first operation may have identified giant cell arteritis, prompting medical therapy against further disease progression.Copyright © 2014 Science International Corp. Key WordsAortic aneurysm · Inflammation · Subclavian artery · Carotid artery Case PresentationAn 82-year-old male of Hungarian descent presented with dilated neck veins and pulsatility in his neck. Preoperative imaging (Fig. 1) identified a 9.3 cm ascending aortic (AscAo) and aortic arch aneurysm, as well as a 4.0 cm innominate artery (InomA), a 2.5 cm right subclavian artery (RScA), and a 2.6 cm left common carotid artery (LCCA). The RScA was at risk of rupturing. Both common carotid arteries were redundant proximally. The maximal diameters of the descending and visceral aorta were 5.8 and 5.0 cm, respectively.In 1989 the patient presented with malaise, extremity joint pain, and fatigue. A biopsy conducted at that time indicated temporal arteritis. The patient selfreported a 1-to 2-month course of prednisone after that admission. In 1993 a 6 cm proximal AscAo aneurysm was resected. The AscAo aneurysm diameter distal to the repair grew to 7.4 cm in 2004, 8.2 cm in 2007, and 9.3 cm in 2011. The patient did not have a history of tobacco abuse, hypertension, or emphysema. He had no family history of aneurysms, although his aunt had temporal arteritis. Three weeks prior to surgery, a percutaneous transluminal coronary angioplasty was performed and a bare metal stent was placed in the left anterior descending artery.Preoperative imaging showed extremely torturous left and right carotid arteries (Fig. 2), as well as apposition of the aneurysm to the previous sternotomy with compression of the vena cava and innominate vein (Fig. 3). Our operative strategy was to (1) maintain continuous cerebrovascular perfusion during initial exclusion of the InomA, RScA, and left common carotid artery, (2) conduct a redo-sternotomy to replace the AscAo and arch aneurysms, and (3) replace the aortic valve. To these ends, a temporary extra-anatomic circuit was constructed. The first step was to perfuse the right and left common carotid arteries, and the right axillary Fax ϩ1 203 785 3346 E-Mail: aorta@scienceinternational.org

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Section: Discussionmentioning

confidence: 99%

Development of Mega-Aorta Following Incompletely Treated Giant Cell Arteritis

Eton

Shah

Merlo

et al. 2014

aorta

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“…The true incidence of giant cell arteritis is unknown, but researchers suggest that the rate in the United States ranges from 0.49 to 27.3 cases per 100,000 population among persons older than age 50 years. 10 Clinical presentation Patients with three or more of the following criteria may have giant cell arteritis: 11 • age 50 years or older • new-onset localized headache • temporal artery tenderness or decreased temporal artery pulse • ESR of at least 50 mm/hour • abnormal artery biopsy specimen characterized by mononuclear infi ltration or granulomatous infl ammation.…”

Section: Review Articlementioning

confidence: 99%

Three common ophthalmic emergencies

Wyatt¹

2014

Journal of the American Academy of Physician Assistants

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“…The true incidence of GCA is unknown, with incidences ranging from 17.8 per 100,000 persons older than 50 years 21 to incidence reports ranging from 0.49 to 27.3 per 100,000 in the United States. 22 The incidence of GCA is positively associated with increasing latitude, making GCA more common in Scandinavian countries. 23 Moreover, aging is the greatest risk factor for developing GCA; it rarely occurs before the age of 50 years.…”

Section: Epidemiology Of Giant Cell Arteritismentioning

confidence: 99%

Current Controversies in Large-Vessel Inflammatory Vasculitis and Thoracic Aortic Aneurysm Disease

et al. 2019

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Large-vessel vasculitis encompasses the spectrum of vasculitides, which pathologically cause chronic granulomatous inflammatory changes, primarily in the aorta and its major branches. These patients are at risk of developing life-threatening aortic lesions that, without recognition and prompt treatment, can cause detrimental effects. Many provocative issues surrounding large-vessel vasculitis and its surgical treatment still remain, spanning from recognition to management. In this review, we discuss the main large-vessel vasculitides, Takayasu's arteritis and giant cell arteritis. We include the key points and current controversies surrounding diagnostic imaging, timing of interventions, and patient outcomes.

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Progress in Gerontology: Polymyalgia Rheumatica and Temporal Arteritis

Cited by 21 publications

References 106 publications

Development of Mega-Aorta Following Incompletely Treated Giant Cell Arteritis

Development of Mega-Aorta Following Incompletely Treated Giant Cell Arteritis

Three common ophthalmic emergencies

Current Controversies in Large-Vessel Inflammatory Vasculitis and Thoracic Aortic Aneurysm Disease

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