Complete evaluation of the cardiovascular lesions in 24 patients with Takayasu's aortitis using four-image, intravenous digital subtraction angiography.

We studied the entire distribution of cardiovascular lesions with the use of intravenous digital subtraction angiography (DSA) in 24 patients having Takayasu's aortitis. The aorta, its branches, pulmonary vessels, and left ventricle were assessed by neck (anteroposterior), abdominal (anteroposterior), and chest (right and left anterior oblique) images. DSA showed multiple arterial lesions (n = 24) including proximal renal artery stenoses (n = 4), pulmonary arterial stenoses (n = 4), inferior-superior mesenteric arterial anastomoses (n = 3), brachiocephalic arterial aneurysms (n = 2), aortic root aneurysm (n = 1), diffuse left ventricular hypokinesis (n = 1), subclavian steal phenomenon (n = 1), and right aortic arch (n = 1). The incidence of total occlusion was highest in the right subclavian artery (n = 12). Average percent luminal stenosis (mean +/- S.D.) over the aorta and its branches tended to be smaller in patients with prior corticosteroid therapy (17.3 +/- 14.6%) than in those without (22.0 +/- 9.8%), but the difference was not significant. DSA (four-series) was useful in assessing the whole disease spectrum and often revealed subclinical lesions in this disease.