Young lady came to the vascular surgery clinic with history body pains, neck pains and prominent pulsations in the neck. Shegave history of loss of weight and loss of appetite. She noticed low grade fever intermittently with flu like symptoms. On examination there was tenderness in the carotid artery triangle on both the sides and pulsations were felt prominently. Spiral angiogram showed ( see figure) multiple dilatations of the aorta and its branches. The carotid artery dilatations are visible and matching the clincal sites of tenderness. It is a challenge to plan the treatments for her, she needs medical therapies initially to reduce the acute inflammatory symptoms and signs. Later the residual lesions can be considered for interventions if they are of hemodynamic significance.
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