A NEW prospective study has revealed that patients with Takayasu arteritis (TA) who present with high ischemic deficits on computed tomography perfusion (CTP) scans face a significantly increased risk of cerebral vascular ischemic events (CVIEs), including stroke and vision loss.
The research followed 81 patients with TA affecting the supra-aortic trunks. Over a median of 16 months, 16 patients experienced CVIEs, the majority of which were ischemic strokes. Investigators found that the volume of ischemic deficit—measured as brain tissue with delayed blood flow (Tmax >6 seconds)—was strongly linked to adverse neurological outcomes.
Statistical analysis showed that patients with higher ischemic deficits had more than a 15-fold increased risk of developing CVIEs. Lower hemoglobin levels also emerged as a protective factor, while use of tocilizumab was associated with greater risk.
Patients were further stratified into three clusters: an inflammation-dominant group, a non-inflammatory group, and an inflammation with low-perfusion group. Those in the third cluster carried the highest risk of CVIEs and poor outcomes, underscoring the importance of combining perfusion imaging with inflammatory markers for risk assessment.
“These findings highlight the need for early identification of high-risk patients using perfusion imaging,” the authors noted, adding that proactive management may help prevent devastating complications such as stroke, blindness, and death.
Reference
Chen R et al. High ischemic deficit in computed tomography perfusion is a risk factor for cerebral vascular ischemic events in Takayasu arteritis: a prospective observational study. BMC Rheumatol. 2025;DOI: 10.1186/s41927-025-00551-6.
