Endovascular Treatment of Intracerebral Giant Cell Arteritis

Claus Z Simonsen; Lasse Speiser; Ib Tønder Hansen; David Jayne; Paul von Weitzel-Mudersbach

doi:10.3389/fneur.2020.00287

Endovascular Treatment of Intracerebral Giant Cell Arteritis

Front Neurol. 2020 Apr 16:11:287. doi: 10.3389/fneur.2020.00287. eCollection 2020.

Authors

Claus Z Simonsen¹, Lasse Speiser², Ib Tønder Hansen³, David Jayne⁴, Paul von Weitzel-Mudersbach¹

Affiliations

¹ Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
² Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark.
³ Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
⁴ Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.

Abstract

Background: Giant cell arteritis (GCA) is the most common primary systemic vasculitis predominantly affecting large and medium sized vessels. In rare cases, the vasculitis can affect the vessels of the brain. Results: We describe four cases of GCA with involvement of the cerebral vessels causing stroke. These cases were unresponsive to aggressive immunosuppression and we opted to treat with endovascular balloon dilatation of the stenotic areas. The procedure was safe. The four patients were treated in nine sessions and a total of 16 vessels were treated. We observed two dissections with no clinical influence on the patients. Discussion: In patients with stroke due to progressive GCA that is non-responsive to immunosuppression, endovascular therapy is feasible.

Keywords: endovascular therapy; giant cell arteritis; immunosuppression; stroke; vasculitis.

Publication types

Case Reports