[Arterial lesions of the upper limbs in Horton disease. Surgical revascularization by bilateral carotid-humeral bypass]

Abstract

Background: While external carotid lesions predominate, giant cell arteritis (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 improved 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 clinical signs do appear, they generally respond well to corticosteroid therapy. In certain cases, as reported here, improvement can only be obtained by surgical revascularization.