RT Journal Article
SR Electronic
T1 Involvement of the Femoropopliteal Arteries in Giant Cell Arteritis: Clinical and Color Duplex Sonography
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.110566
DO 10.3899/jrheum.110566
A1 Michael Czihal
A1 Federico Tatò
A1 Antje Rademacher
A1 Peter Kuhlencordt
A1 Hendrik Schulze-Koops
A1 Ulrich Hoffmann
YR 2012
UL http://www.jrheum.org/content/early/2012/01/12/jrheum.110566.abstract
AB Objective To determine the extent and clinical significance of giant cell arteritis (GCA) of the femoropopliteal arteries. Methods This was a retrospective clinical color duplex sonography (CDS) study; 60 of 112 consecutive patients with the diagnosis of GCA underwent complete clinical examination of the lower extremities including the vasculature, systolic ankle pressure measurement, and CDS scans of the femoropopliteal arteries within 1 year after diagnosis of GCA. Circumferential, hypoechogenic, homogenous wall thickening was regarded as a hallmark of femoropopliteal GCA. Results GCA of femoropopliteal arteries was present in 32 (53.3%) of 60 patients. In general, femoropopliteal GCA developed bilaterally (100%) and 14 patients (23.3%) had significant lower extremity artery obstructions secondary to vasculitis, all leading to symptomatic lower extremity ischemia, with development of critical leg ischemia in 4 patients. Compared with subjects without lower extremity vasculitis, patients with femoropopliteal involvement had a significant time delay until diagnosis (mean 23.9 vs 11.1 weeks; p = 0.03) and a higher frequency of concomitant vasculitis of the arm arteries (74.2% vs 42.9%; p = 0.02). Conclusion Femoropopliteal artery involvement appears to be a clinically relevant manifestation of GCA, frequently leading to symptomatic lower extremity ischemia. CDS of the femoropopliteal arteries is a noninvasive diagnostic tool for detection of lower extremity vasculitis in GCA.