Thoracic aortic aneurysm secondary to giant cell arteritis: a reappraisal of etiology, treatment and possible prevention.

43 patients with thoracic aortic aneurysms (TAA) were treated over a ten-year period at our hospital. Five (11.6%) had giant cell arteritis (GCA). Although many types of arteritis have been reported, all have pathologic features of elastic degeneration and granulomatous inflammation and may share a common underlying etiology. TAA secondary to arteritis frequently involves the ascending aorta, leading to aortic root dilatation and valvular insufficiency. Three of five of our patients had these findings and had successful surgical repair by combined aortic valve and ascending aorta replacement. Patients with TAA secondary to arteritis should be investigated further, looking for evidence of additional arterial disease. Because corticosteroids have prevented the progression of other types of arteritis, further investigation of their efficacy in the treatment of giant cell arteritis may be warranted.