Aortic Aneurysms in Takayasu Arteritis

Takayasu arteritis is a non-atherosclerotic chronic inflammatory vascular disease of unknown etiology that affects the aorta, proximal parts of its major branches and the pulmonary arteries. The disease may cause stenosis, occlusions and sometimes aneurysm formation in the aorta and/or the affected arteries. As the use of arteriography gradually became a more widespread and the procedure was more generally available, more details of the disease and its manifestation began to be described. From the historical perspective, Mikito Takayasu is credited with having been the first to describe the disease in 1908, when he presented a case of a 21-year old woman with a peculiar optic fundus abnormality, characterized by arteriovenous anastomosis around the papilla (fig. 1). He made no mention of whether or not radial pulses were absent or diminished. Two other ophthalmologists, Onishi and Kagoshima, also described patients very similar to the one described by Takayasu, adding that their patients had no radial pulses. This is why nowadays, the disease is called Takayasu-Onishi aorto-arteritis. Probably the first description of the disease we now call Takayasu arteritis was actually done by Giovan Battista Morgagni in 1771. Patients with pulseless disease or aortic syndrome were also described by Adams in 1827, Devy in 1839 and William Broadbent in 1875. In 1856, the English surgeon William Savory described pathological and clinical examination findings in a patient who died of pulseless disease and aortic arch syndrome. In this 22-year old woman, autopsy revealed obliteration of left internal carotid artery, together with bilateral subclavian artery occlusion. Histological descriptions of Takayasu arteritis were reported by Beneke in 1925 and Harbitz in 1926.