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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2012 June;25(3):169-72
Extra-anatomical bypass surgery for progressive cerebral ischemia caused by Takayasu’s arteritis
Chen J., Yao Q., Zhang J., Wang T., Fan J., Wang H., Lv Y., Wang L.
Department of Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, China
Aim. Takayasu’s arteritis is a nonspecific autoimmune inflammation manifested with systemic large vessel vasculitis which affects predominantly the aorta and its main branches. In this article we report on six women who presented rapidly progressive cerebral ischemia caused by Takayasu’s arteritis.
Methods. Severe stenosis of bilateral carotid arteries were present in 5 and occluded left subclavian artery in 1 case. Based on clinical and angiographic findings, the diagnosis of Takayasu’s arteritis was established. Extra-anatomical bypasses from the external iliac artery to both internal carotid arteries were performed in 4 cases. Bypasses from right subclavian artery to both internal carotid arteries were performed in 1 case and bypass from the left external iliac artery to left subclavian artery in 1 case.
Results. After operation, acute thrombosis of graft developed in 2 cases, one of them received emergent thromboembolectomy and recovered successfully. Overall, the cerebral ischemic symptoms disappeared in 5 cases and all of them remained asymptomatic during the follow up from 8 to 24 months.
Conclusion. Our surgical experience introduced here indicates that the extra-anatomic bypass surgery is a feasible option if there is sufficient blood pressure gradient.