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Diagnosis and Management of Aortic Disease

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83 Table 35. Diagnostic Criteria for Inflammatory Aortitis Names Criteria Used in Diagnosis/Source When Is Diagnosis Established? Takayasu arteritis Age of onset <40 y ≥3 criteria are present (sensitivity 90.5%; specificity 97.8%) Intermittent claudication Diminished brachial artery pulse Subclavian artery or aortic bruit Systolic BP variation of >10 mm Hg between arms Aortographic evidence of aorta or aortic branch stenosis Giant cell arteritis Age >50 y ≥3 criteria are present (sensitivity >90%; specificity >90%) Recent-onset localized headache Temporal artery tenderness or pulse attenuation Elevated erythrocyte sedimentation rate >50 mm/h Arterial biopsy shows necrotizing vasculitis Originally published in Hiratzka, et al. 2019. Circulation. 2010;121:e266-e369. 9.2.1. Diagnosis and Management of Infection of the Native Aorta COR LOE Recommendations 1 C-EO 1. In patients with infectious aortitis and associated aneurysms or dissection of the thoracic or abdominal aorta, open surgical repair is recommended. 2b C-LD In select patients, treatment with endovascular repair may be considered. 2a C-EO 2. In patients with infectious aortitis complicated by rupture, either open or endovascular repair is reasonable, based on the patient's status at presentation and institutional expertise. 2b C-EO 3. In patients with infectious aortitis, intravenous antimicrobial therapy of at least 6 weeks' duration may be considered, with lifelong suppressive therapy in select cases not amenable to interventional repair or who have recurrent infection.

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