Commentary
arteritis in Western surgical
practice
N J M London
Leicester
University, Leicester, UK
Correspondence to: Professor N J M London, Department of Surgery, Faculty of Medicine and Biological Sciences, Robert Kilpatrick Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX, UK
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Arteritis is defined as inflammation of the arterial wall and
may result in arterial occlusion, aneurysm formation, or haemorrhage. The nomenclature and classification of arteritis is complex and confused. From a surgical perspective, however, the most useful classification is based on the size of the involved artery (box 1). The
commonest large artery arteritides encountered in Western surgical
practice are giant cell arteritis (GCA) and radiation induced
arteritis. GCA may present to the ophthalmic surgeon with visual
disturbance or to the vascular surgeon with aneurysms or stenoses of
the aorta or its main branches. While I would agree with Ehrenfeld
et al that it is not cost effective to
screen patients presenting with aortic aneurysms for GCA, it is
important that vascular surgeons are alert to the association of GCA
with aortic aneurysm (particularly thoracic). This is because surgical
reconstruction in the acute phase of GCA without steroid cover has
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