Large-vessel involvement in giant cell arteritis

Curr Opin Rheumatol. 2006 Jan;18(1):10-7. doi: 10.1097/01.bor.0000197996.04709.4e.


Purpose of review: Large-vessel involvement in giant cell arteritis occurs in over a quarter of patients with this disease. Stenosis of the primary and secondary branches of the aorta may cause claudication and tissue gangrene, whereas aortitis may lead to aneurysm formation and dissection, often many years after the initial diagnosis.

Recent findings: Subsets of giant cell arteritis are probably caused by variations in the pathobiology of the disease. Radiographic imaging with some form of angiography is essential to reach a proper diagnosis. Although survival in giant cell arteritis is generally good, subsets of patients with aneurysm formation have a markedly diminished life expectancy. Glucocorticosteroids continue to be the mainstay of treatment for giant cell arteritis and its complications.

Summary: Advances in diagnostic techniques including proteomic and genomic approaches should improve our understanding of the pathogenesis as well as the assessment of disease activity and extent. We provide a suggested algorithm for the evaluation of patients with large-vessel disease in giant cell arteritis.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Aortic Aneurysm / diagnosis
  • Aortic Aneurysm / etiology
  • Aortic Aneurysm / pathology
  • Aortic Aneurysm / therapy
  • Aortic Diseases / diagnosis*
  • Aortic Diseases / etiology
  • Aortic Diseases / pathology
  • Aortic Diseases / therapy
  • Aortitis / diagnosis
  • Aortitis / etiology
  • Aortitis / therapy
  • Constriction, Pathologic
  • Giant Cell Arteritis / complications
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / therapy
  • Humans