Morphological mural changes in the aorta in non-specific aortoarteritis (Takayasu's arteritis): Assessment by intravascular ultrasound imaging

Abstract

Non-specific aortoarteritis (Takayasu's arteritis) is a panarteritis of unknown aetiology which primarily involves the vessel walls. The imaging morphology of wall abnormalities has been infrequently studied and their intravascular ultrasound appearance is not reported in the literature. We studied this morphology by intravascular ultrasound in nine patients in whom the diagnosis of Takayasu's arteritis was made by clinical and angiographic criteria. Intravascular ultrasound was performed by the transfemoral route. Images of the aorta were obtained in each patient. Qualitative and quantitative analysis was performed. All procedures were successful, without complication. Typical findings included thickening and altered echogenicity of the media, adventitia and peri-arterial tissues. The inner echogenic layer was thin. Pliability of aortic walls was lost in stenotic segments. Aortic calcification was seen in one patient. The aortic wall thickness was 0.17-0.58 cm. Angiograms showed skip areas of aortic involvement. Intravascular ultrasound showed wall changes even in the skip areas which were normal at angiography. Intravascular ultrasound shows changes in the aortic wall morphology in non-specific aortoarteritis. Our findings suggest that this disease involves contiguous aortic segments, producing wall and luminal changes in some areas and only wall changes in intervening areas.