P. Soury et al., ARTERIAL LESIONS OF THE UPPER LIMBS IN GI ANT-CELL ARTERITIS (HORTONS-DISEASE) - SURGICAL REVASCULARIZATION WITH BILATERAL CAROTID-HUMERAL BYPASS, La Presse medicale, 26(31), 1997, pp. 1478-1480
BACKGROUND: While external carotid lesions predominate, giant cell art
eritis (Horton's disease) involves the arteries of the upper limbs in
7.7 to 16% of the patients. CASE REPORT: We cared for one patient with
clinically and biologically proven Horton's disease. The patient was
given corticosteroid therapy, but although general health status impro
ved and markers of the inflammatory reaction returned to normal levels
, exertion-induced ischemia progressively worsened. Due to the length
of the arterial lesions, we performed bilateral carotid-humeral bypass
surgery. DISCUSSION: Clinical expression of Horton's disease is often
quiescent even in cases with extensive anatomic lesions. When clinica
l signs do appear, they generally respond well to corticosteroid thera
py. In certain cases, as reported here, improvement can only be obtain
ed by surgical revascularization.