Novel Angiographic Scores for evaluation of Large Vessel Vasculitis

Enrico Tombetti, Claudia Godi, Alessandro Ambrosi, Frances Doyle, Alana Jacobs, Allan P. Kiprianos, Taryn Youngstein, Katie Bechman, Angelo A. Manfredi, Ben Ariff, Justin C. Mason
2018 Scientific Reports  
Arterial involvement is the cardinal feature of large-vessel vasculitis (LVV) and prevention of disease progression is the principal therapeutic goal. However, development of tools for its evaluation represents a major unmet need. To address this, a widely-applicable imaging tool for LVV, analysing arterial involvement in 17 arterial territories, has been developed and validated. Individual stenosis and dilation scores were generated and combined in a composite score. The methodology was
more » ... ed cross-sectionally and longitudinally in 131 patients, 96 Takayasu arteritis (TA), 35 large-vessel giant-cell arteritis (LV-GCA). In total, 4420 arterial segments from 260 imaging studies were evaluated. The new scores allowed quantitative grading of LVV arterial involvement with high consistency, revealing inter-patient differences. TA had higher stenosis and composite scores and lower dilation scores than LV-GCA. Baseline stenotic and composite scores reflected arterial damage rather than disease-activity. Longitudinal changes in all three scores correlated with disease activity and mirrored arterial disease evolution, reflecting both progressive injury and lesion improvement. Increases ≥1 in any score were specific for arterial disease progression. The scores objectively quantify arterial involvement in LVV, providing precise definition of disease phenotype and evolution. We propose that they represent novel vascular outcome measures essential for future clinical trials.
doi:10.1038/s41598-018-34395-7 pmid:30374116 pmcid:PMC6206009 fatcat:erm3y6dgzvh5rpkk7ehglm62cq