What is the usual pattern of affected arteries in giant cell arteritis (GCA) (temporal arteritis)?

Updated: Sep 10, 2020
  • Author: Mythili Seetharaman, MD; Chief Editor: Herbert S Diamond, MD  more...
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The superficial temporal artery is involved in most patients, providing a convenient biopsy site, but this is only the "tip of the iceberg." GCA commonly affects arteries in the following pattern:

  • Common, external, and internal carotid artery involvement is usually extracranial; rarely, proximal intracranial segments have been affected

  • Intraorbital branches, especially the posterior ciliary and ophthalmic arteries, are commonly affected

  • Vertebral arteries are involved as frequently as the superficial temporal arteries in fatal cases, although basilar artery involvement is rare

  • Vertebral arteritis is extracranial, but it may extend intracranially for roughly 5 mm beyond dural penetration

  • Subclavian, axillary, and proximal brachial arterial involvement produces a characteristic angiographic pattern of vasculitis, consisting of long, smooth, stenotic segments that alternate with nonstenotic segments and tapered occlusions

  • Involvement of the ascending aorta can lead to aortic rupture, and coronary arteritis may result in myocardial infarction (MI)

  • Less often, the descending aorta and mesenteric, renal, iliac, and femoral arteries can be affected, with attendant complications of intestinal infarction, renal infarction, crural infarction, and ischemic mononeuropathies [20, 21]

  • Pulmonary arterial involvement has also been described

  • Some veins may be affected occasionally

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