022 - A Review of the Diagnostic Criteria and Management of Takayasu Arteritis
Geogy Vatakencherry, MD – Program Director, Vascular Interventional Radiology, Kaiser Permanente
Purpose: Takayasu Arteritis (TA) is a large vessel vasculitis mainly affecting the aorta and its branches. Currently, there are no ideal diagnostic studies in detecting TA in a symptomatic patient. Diagnosing TA remains a universal challenge as most diagnoses are made once the disease has progressed.1 Various forms of criteria have been made for the diagnosis of TA, each of which is of interest for further review of their efficacies. These criteria contain values for laboratory studies, imaging studies, and symptomatology. This study aims to collect a comprehensive review of previous research articles assessing the power of current criteria guidelines for the diagnosis and management of TA.2
Material and Methods: PubMed was screened for relevant articles using the MeSH search term for Takayasu arteritis diagnosis with pertinent information related to the use of computed tomography (CT), magnetic resonance angiography (MRA), positron emission tomography (PET), transesophageal echocardiography (TEE), or ultrasound (US) from 2000 to 2022. Logistic regression will be used to calculate correlations between these imaging modalities and symptoms, including limb claudication, pulselessness, pulse differences in limbs, fever, neck pain, changes in vision, syncope, dyspnea, palpitations, hypertension, aortic regurgitation, and carotid artery tenderness. Additional specific searches for Ishikawa criteria and the Modified Ishikawa criteria were also investigated amongst the literature review.
Results: A total of 1282 articles were found meeting our initial search criteria. Following abstract and full-text screening, we aim to find the sensitivities and specificities between symptomatic presentation, diagnostic imaging choice, and positive criteria driven diagnosis of Takayasu arteritis along with the management guidelines post-diagnosis.
Conclusions: Further investigation will be needed to definitively identify associations between symptomatic presentation, diagnostic imaging choice, and positive diagnosis of Takayasu arteritis.
1. Kim ESH, Beckman J. Takayasu arteritis: challenges in diagnosis and management. Heart. 2018;104(7):558-565. doi:10.1136/heartjnl-2016-310848 2. Sharma BK, Jain S, Suri S, Numano F. Diagnostic criteria for Takayasu arteritis. International Journal of Cardiology. 1996;54:S141-S147. doi:10.1016/S0167-5273(96)88783-3