CASE REPORTS   

Panminerva Medica 1999 June;41(2):161-70

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Non specific aorto-arteritis. Clinical picture, diagnosis and therapy

Miani S., De Monti M., Keller G., Bordoni M. G., Bianchi E., Giordanengo F.

From the Istituto di Chirurgia Generale e Cardiovascolare Università degli Studi, Milano, Italy

This ­study is ­aimed at ana­lyzing clin­ical fea­tures, angio­graphic find­ings and evo­lu­tion of Takayasu’s arter­itis and the cri­teria ­adopted to estab­lish the indi­ca­tion for non-sur­gical ­versus oper­a­tive treat­ment. Eighteen ­patients ­affected by non spe­cific ­aort-arter­itis ­were ­observed and ­treated at our Department ­between 1973 and 1996. All ­patients met the American College of Rheumatology 1990 cri­teria of clas­sifi­ca­tion of Takayasu’s arter­itis. Sixteen ­patients ­were ­young ­females. Two ­patients ­were ­males. Nine ­patients under­went sur­gical pro­ce­dures. One ­young ­female under­went a PTA. All ­eight asymp­to­matic ­patients ­were ­only med­i­cally ­treated. One ­patient ­died ­some ­days ­after an ­aorto-bica­rotid by­pass ­graft due to ­acute myo­car­dial infarc­tion. Two ­other ­patients ­died two and ­four ­years ­after inter­ven­tion for ­renal and car­diac ­failure respec­tively. One ­patient ­after an ­aorto bica­rotid ­bypass under­went a ­left hem­i­plegia due to throm­bosis of the ­right ­graft ­branch. All the ­other 14 ­patients ­either sur­gi­cally or med­i­cally ­treated are ­well and are ­under ­strict sur­veil­lance ­through rig­orous ­follow-up. The 10 ­patients who under­went sur­gical or inter­ven­tional radio­log­ical treat­ment ­were cer­tainly the ­most seri­ously ­affected ­patients and ­were symp­to­matic (pre­sented neu­ro­log­ical dis­tur­bances or a ­severe hyper­ten­sive ­state). This ­fact ­explains, to ­some ­extent, the mor­tality and mor­bidity ­rate ­observed in ­this ­group. The ­seven med­i­cally ­treated ­patients ­were com­pletely asymp­to­matic in ­spite of a ­major involve­ment of var­ious vas­cular dis­tricts.