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Year : 2003  |  Volume : 13  |  Issue : 1  |  Page : 61-66
Aortoarteritis : A study of 33 central Indian patients

Dept. of Radiodiagnosis, Govt. Medical College, Nagpur-440003, India

Correspondence Address:
R G Salkar
Dept. of Radiodiagnosis, Govt. Medical College, Nagpur-440003
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Source of Support: None, Conflict of Interest: None

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OBJECTIVE : To evaluate the clinical profile, complications, site of involvement and response to therapy and interventional management of aortoarteritis. MATERIAL AND METHODS : 33 patients with Aortoarteritis were studied over a period of two years between Jan 2001 to Nov 2002. Data on clinical features, laboratory and angiographic findings, disease course, response to therapy and interventional management were all recorded and stored in a computer based retrieval system. RESULTS : In our series of 33 patients (21 female, 12 male) with angiographically diagnosed Aortoarteritis, females (63.64 percent) were most frequently affected. The median age of onset was 29 years. The clinical presentation ranged from asymptomatic to catastrophic with stroke. Patients had both non-vascular symptoms (fever 21.21 percent, arthralgia 9 percent) and symptom of vascular stenosis such as limb claudication (66.67 percent), headache (66.67 percent), and hypertension due to renal artery Stenosis (42 percent). All patients had either multiple vascular bruits (76 percent), absent pulses (18 percent), or asymmetric pulses (66.67 percent) and blood pressure differences greater than 10 mm hg between arm (66.67 percent). Laboratory findings included elevated erythrocyte sedimentation rate (87.88 percent), C-reactive protein (30.30 percent), one patient had Mantax test positive. However, E.S.R. was not a consistently reliable surrogate marker of the disease activity. Almost all patients had multiple sites of arterial involvement documented by angiogram with various combinations of stenosis, Luminal irregularity and aneurysm formation. Type IV (63.64 percent) (i.e. involvement of abdominal aorta and or renal arteries) was more commonly found in our study. Response to corticosteroid treatment was usually very good, with dramatic improvement in non-vascular symptoms. SIX patients underwent percutaneous transluminal angioplasty involving the abdominal aorta (2 cases), subclavian artery (3cases) and renal artery (lease). CONCLUSIONS : In central India, Aortoarteritis is a rare disease. However, Type IV is more common. It is heterogeneous in presentation, progression, and response to therapy. Current laboratory markers of disease activity are insufficiently reliable to guide management. Most patients require repeated and at times, prolonged course of therapy. After percutaneous transluminal, balloon angioplasty (P.T.A.) clinical parameters were normal. Although mortality was low, substantial morbidity occurred in most patients.

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