Role of temporal artery resection in Horton's arteritis (Review)

Vrinceanu,Daniela; Dumitru,Mihai; Banica,Bogdan; Eftime,Ioana-Silvia; Patrascu,Oana; Costache,Adrian; Cherecheanu,Matei Popa; Georgescu,Madalina Gabriela

doi:10.3892/etm.2021.10533

Role of temporal artery resection in Horton's arteritis (Review)

Authors:
- Daniela Vrinceanu
- Mihai Dumitru
- Bogdan Banica
- Ioana-Silvia Eftime
- Oana Patrascu
- Adrian Costache
- Matei Popa Cherecheanu
- Madalina Gabriela Georgescu
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Affiliations: ENT Department, Emergency University Hospital, 010271 Bucharest, Romania, Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Cardiovascular Surgery, ‘Prof. Dr. Agrippa Ionescu’ Emergency Clinical Hospital, 011356 Bucharest, Romania, Clinical and Hearing Aid Department, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
Published online on: August 2, 2021 https://doi.org/10.3892/etm.2021.10533
Article Number: 1099
Copyright: © Vrinceanu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Horton's arteritis is found in the literature under various names, such as temporal arteritis, Horton's disease senile arteritis, granulomatous arteritis or giant cell arteritis (GCA). The pathogenic mechanism is the result of an inflammatory cascade triggered by a still unknown factor that causes dendritic cells in vessels to recruit T cells and macrophages, which form granulomatous infiltrates. The clinical picture consists of a daily headache with temporal localization, with moderate to severe intensity, unilateral or bilateral, with a history of months, years. Other changes may include pain in the cheek or tongue during chewing (claudication), weight loss, generalized fatigue, low‑grade fever, and frequent pain in the limbs, in the context of coexisting rheumatic polymyalgia. Visual symptoms represent a special category, involving blurred vision, scotomas, and even sudden blindness. Histopathological examination of the temporal artery biopsy reveals focal thickening of the intima, with interruption of the lamina propria, with transmural inflammatory infiltrates, sometimes with multinucleated giant cells. In this article, we aim to review the role of temporal artery resection in the diagnosis of Horton's arteritis, but we also discuss the hypothesis of a potential therapeutic benefit of this procedure. However, there are also clinical situations in which there has been a considerable improvement in clinical symptoms and especially in vision deficit, with the improvement of the visual field after surgery performed for biopsy. It is difficult to estimate the influence of temporal artery resection alone, given that most patients also have concomitant cortisone treatment. However, in some cases, the rapid improvement of symptoms immediately after surgery, with the improvement of visual acuity and visual field, along with the disappearance of the headaches, can create the premises for future studies on a therapeutic contribution of temporal artery resection in GCA.

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