Management of aneurysms in takayas arteritis

Vasculitis is a rare disease associated with in fl ammatory response of vessel walls, with or without associated necrosis and granulomata. It affects 20 individuals per million a year. Chronic in fl ammation can weaken or thicken the arterial wall, leading to aneurysm, stenoses, and occlusions. Systemic vasculitides have varied etiologies and pathogenetic mechanisms, yet most have not been well de fi ned. Vasculitides are classi fi ed according to the vessel size and presence or absence of necrosis, granulomas, or both (Table 24.1). Large-vessel vasculitis affects the aorta and its branches, medium-size vessel vasculitis has a predilection for the visceral arteries, and small-vessel vasculitis affects arterioles, venules, and capillaries. Although vasculitis of the mesenteric arteries is rare, accounting for less than 5 % of all cases of mesenteric ischemia [2], it can lead to bowel gangrene and death if not immediately recognized and treated. This chapter summarizes the clinical features, diagnostic approaches and treatment of mesenteric vasculitis (MV).