{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:34:47Z","timestamp":1786725287909,"version":"build-2736575974"},"reference-count":71,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Pers. Med.","JPM"],"abstract":"<jats:p>Aortitis\u2014inflammation of the aortic wall\u2014presents at the interface of vasculitis, infection, structural aortic disease, and cardiovascular risk. It may occur in giant cell arteritis (GCA), Takayasu arteritis, immunoglobulin G4 (IgG4)-related disease, drug-induced injury, infection, or as an isolated finding after aortic surgery. Modern imaging detects aortic inflammation more frequently, but the main challenge is classification rather than detection: determining whether disease is infectious or immune-mediated, active or dominated by fixed structural damage, systemic or isolated, and whether the dominant threat is aneurysm, dissection, undertreated infection, or avoidable immunosuppression. This review considers aortitis as a high-risk vascular syndrome requiring aetiology-first classification rather than descriptive labelling. Before escalating immunosuppression, infection must be actively excluded and inflammatory activity distinguished from fixed vascular damage. Treatment should be individualised according to phenotype, age, vascular territory, comorbidity, and toxicity risk, with surveillance continuing even after symptoms and inflammatory markers improve. Optimal care depends on multidisciplinary assessment integrating rheumatology, infectious diseases, vascular surgery, radiology, and cardiology expertise. Progress will require standardised imaging definitions, registries linking inflammatory control with structural vascular outcomes, and validation of artificial intelligence (AI) tools before clinical adoption.<\/jats:p>","DOI":"10.3390\/jpm16080430","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:48:36Z","timestamp":1786722516000},"page":"430","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aortitis as a High-Risk Vascular Syndrome: Integrating Phenotype-Driven Diagnosis, Multidisciplinary Assessment, and Personalised Management"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1667-3172","authenticated-orcid":false,"given":"Georgios P.","family":"Georghiou","sequence":"first","affiliation":[{"name":"Department of Surgery, Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"School of Medicine, European University Cyprus, Egkomi, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klitia","family":"Socratous","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Egkomi, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2259-5004","authenticated-orcid":false,"given":"Sotiris","family":"Kyriakou","sequence":"additional","affiliation":[{"name":"Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Lampropoulos","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Egkomi, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7523-9786","authenticated-orcid":false,"given":"Panos","family":"Georghiou","sequence":"additional","affiliation":[{"name":"Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Georgiou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Krankenhaus Maria-Hilf, 47805 Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilina","family":"Neokleous","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cyprus, Aglanztia, Nicosia 2029, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iakovos","family":"Ttofi","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Egkomi, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5114-7020","authenticated-orcid":false,"given":"Nikolas","family":"Iosif","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, Hepatologie, Endokrinologie, Diabetologie, Helios Universit\u00e4tsklinikum, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippos","family":"Triposkiadis","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Egkomi, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1161\/CIRCULATIONAHA.107.760686","article-title":"Aortitis","volume":"117","author":"Gornik","year":"2008","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1136\/heartjnl-2020-318085","article-title":"Aortitis: Recent advances, current concepts and future possibilities","volume":"107","author":"Pugh","year":"2021","journal-title":"Heart"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"621","DOI":"10.3949\/ccjm.91a.24030","article-title":"Incidentally detected noninfectious thoracic aortitis: A clinical approach","volume":"91","author":"Clifford","year":"2024","journal-title":"Cleve. 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