ORIGINAL ARTICLES   

Chirurgia 2011 December;24(6):307-13

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

The effectiveness and safety of aorto-carotid bypass for patients with Takayasu’s arteritis

Roh Y-N. ¹, Lee K-B. ¹, Kim Y-W. ¹, Sung K-I. ², Kim D-I. ¹

¹ Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Department of Thoracic & Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Aim. Takayasu’s arteritis is considered to be a medically controllable disease. Yet severe cerebrovascular ischemia is regarded as an indication for invasive intervention. We reviewed our experiences with performing aorto-carotid bypass for treating patients with cerebrovascular ischemia due to Takayasu’s arteritis.
Methods. A retrospective review was performed on 9 patients with Takayasu’s arteritis and who underwent aorto-carotid bypass from 1998 to 2009 in our hospital.
Results. All the patients showed occlusion of the common carotid arteries or aortic arch, and they suffered from severe cerebrovascular ischemia before surgery. In 8(89%) patients, the ischemic symptoms related with arterial occlusion were resolved after surgery. None of the patients experienced any anastomosis aneurysm postoperatively (mean follow-up duration; 33.2 ± 26.7 months, range: 1~70 months). But one patient who underwent aorto-bicarotid bypass showed occlusion of one graft limb. In the early operation group, any post-operative blood pressure fluctuation was rare, but in the late operation group, blood pressure fluctuation after surgery was common, and one patient from this group ultimately experienced intracranial hemorrhage on the 8th postoperative day.
Conclusion. Aorto-carotid bypass is effective and safe for treating patients with cerebrovascular ischemia due to Takayasu’s arteritis, and we suggest that an early operation can reduce the postoperative blood pressure fluctuation and the risk of complications.