CASE REPORT   

Journal of Radiological Review 2020 July-August;7(4):325-33

DOI: 10.23736/S2723-9284.20.00020-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

Takayasu’s arteritis: a typical case of a rare disease

Alberto PACIELLI ¹ ✉, Michele BINI ², Giuseppe STRANIERI ², Manuela SANDRONE ³, Giacomo P. VAUDANO ³, Daniele SAVIO ³, Roberta FENOGLIO ⁴

¹ Institute of Radiology, Città della Salute e della Scienza, Turin, Italy; ² Department of Radiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy; ³ Department of Radiology, San Giovanni Bosco Hospital, Turin, Italy; ⁴ Department of Nephrology, San Giovanni Bosco Hospital, Turin, Italy

Takayasu arteritis (TA) is a chronic, idiopathic, inflammatory disease that primarily affects large vessels, such as the aorta and its major branches, pulmonary and coronary arteries. Here we discuss a case of a 33-year-old woman affected by Takayasu’s arteritis without subclavian involvement, referred to our Center to investigate and treat arteritis- derived hypertension. After a thorough clinical, laboratory and imaging examination, we found a marked stenosis of left renal artery, so we decide to perform an angioplasty to restore good vessel patency; because of minimal intimal dissection occurred during procedure, we placed a stent with a definitive good result. The day after procedure, a CTA study was performed to better evaluate the stenotic arterial segments, scanning from Willis circle to aortic bifurcation. CTA study showed important thickening of left common carotid artery wall with thin and irregular lumen; similar findings were present in the proximal tract of right common carotid artery. Both external and internal carotid artery had a regular appearance, as well as subclavian, vertebral and intra-cranial vessels. The abdominal aorta was involved from aortic iatus to inferior mesenteric artery origin. The soft tissue surrounding arterial walls exhibited contrast enhancement during later scans, confirming the diagnosis of vasculitis. The patient was discharged and directed to our hypertension center for an appropriate follow-up.

KEY WORDS: Takayasu arteritis; Vasculitis; Computed tomography angiography