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Insights into Pathogenesis of Takayasu’s Arteritis

Jason M Springer and Gary S Hoffman

Takayasu’s arteritis (TA) is an idiopathic large vessel inflammatory disease that predominantly affects young women. The pathology includes granulomatous changes. The inflammatory process favors the cervico-cranial vessels of the aortic arch, the thoracic more than the abdominal aorta and produces stenoses 4-5 times more often than aneurysms (Figure 1) [1,2]. Wider global recognition of TA has led to questioning of the accuracy of the longaccepted demographic of an Asian stereotype and the notion that the illness follows a triphasic (systemic, vascular inflammatory and burned out) course. Larger aggregate data has also increased appreciation of persistent disease activity, need for surgical remedies and a greater degree of disability than heretofore recognized. Recent insights into pathogenesis have led to experimental trials of novel therapies. This review will explore these insights and resultant changes in both medical and surgical interventions.