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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
Rivista di Medicina Interna e Farmacologia
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2014 June;173(6):321-8
Surgical management of patients with Takayasu arteritis
Igari K., Kudo T., Toyofuku T., Jibiki M., Inoue Y.
Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
AIM: Takayasu arteritis (TA) is primarily treated by pharmacological therapy, but surgical treatment may also be required for organ ischemia, renovascular hypertension or aneurysmal lesions. The aim of this study was to report our experience with the surgical management of patients with TA and to evaluate the outcomes.
METHODS: A total of five patients underwent surgical treatment from January 1997 to December 2011. We reviewed the clinical features, lesion characteristics and indications for surgical treatment. To evaluate the treatment results, we assessed the early complications, the patency of the reconstructed arteries, recurrent symptoms and long-term complications.
RESULTS: Four patients had stenotic and/or occlusive lesions, and one patient had an aneurysm. Six bypass surgeries in four patients were performed, and one endovascular treatment was performed. During a mean follow-up of 99 months (median, 91; range 44 – 178 months), there was one bypass graft occlusion (16%). There was no enlargement of the aneurysm in the patient treated with the endovascular technique.
CONCLUSION: Our treatments were feasible for TA patients. Historically, endovascular treatment of TA with occlusive lesions has been associated with poor outcomes with respect to patency. However, in our case with an aneurysmal lesion, the endovascular technique provided a safe, effective and durable treatment.