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ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 12
Short communication

New endovascular techniques for treatment of life-threatening Takayasu arteritis

Marek Kazibudzki, Łukasz Tekieli, Mariusz Trystuła, Piotr Paluszek, Zbigniew Moczulski, Piotr Pieniążek

Adv Interv Cardiol 2016; 12, 2 (44): 171–174
Online publish date: 2016/05/11
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Takayasu arteritis (TA) is a medium-size and large artery vasculitis of unknown aetiology affecting mainly the aorta and its major branches, usually in young female patients. Histopathology reveals adventitial thickening, focal lymphocytic infiltration of the tunica media and intimal hyperplasia leading to artery stenosis/occlusion. Less commonly media degeneration presents as aneurysmal dilatation [1]. Clinical symptoms arise from systemic inflammation and local vascular complications. Neurological manifestation of the disease includes headache, dizziness, visual disturbance, transient ischemic attack (TIA) and stroke [2]. Takayasu arteritis may be associated with premature mortality among young patients. Mortality is significant (3–11%) and varies according to geographical location and management strategy. The most frequently reported causes of death include stroke, myocardial infarction, congestive cardiac failure, and peri- and postoperative complications. The majority of patients (23%) are unable to work, and about 60% are limited in everyday activities [3, 4].

Case report

We report the case of a 33-year-old woman who was previously diagnosed on the rheumatology ward in January 2014 due to unexplained weight loss, anaemia and highly elevated systemic inflammation markers (C-reactive protein of 129 ng/ml, erythrocyte sedimentation rate of 107 mm/h). These findings were accompanied by severe dizziness and an extremely low value of systemic blood pressure measured on both arms. Doppler ultrasound (DUS) examination followed by computed tomography angiography (angio-CT; Mar 2014) revealed thickening of the descending aorta wall, near-to-occlusion stenosis of both common carotid arteries (CCA), severe stenosis of the right subclavian artery (RSA) and occlusion of the left subclavian artery (LSA) as well as the right axillary artery. According to the criteria of large vessel vasculitis a diagnosis of TA was made [2] and the patient was initiated on a combination therapy of cyclophosphamide, prednisolone and hydrocortisone. Within the next 6 months, she was hospitalized several times due to persistent neurological symptoms including dizziness and drop attacks. In December 2014 clinical deterioration with increased neurological symptoms occurred. The patient was unable to adopt an upright position because of severe dizziness; moreover, right-hemisphere TIA occurred. She was admitted to our Vascular Surgery Department in...

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Kerr GS, Hallahan CW, Giordano J, et al. Takayasu arteritis. Ann Intern Med 1994; 120: 919-2.
Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990. Criteria for the classification of Takayasu arteritis. Arteritis Rheum 1990; 33: 1129-34.
Perera AH, Mason JC, Wolfe JH. Takayasu arteritis: criteria for surgical intervention should not be ignored. Int J Vasc Med 2013; 2013: 618910.
Hedna VS, Patel A, Bidari S, et al. Takayasu’s arteritis: is it a reversible disease? Case report and literature review. Surg Neurol Int 2012; 3: 132.
Kim YW, Kim DI, Park YJ, et al. Surgical bypass vs endovascular treatment for patients with supra-aortic arterial occlusive disease due to Takayasu arteritis. J Vasc Surg 2012; 55: 693-700.
Ham SW, Kumar SR, Rowe VL, et al. Disease progression after initial surgical intervention for Takayasu arteritis. J Vasc Surg 2011; 54: 1345-51.
Saadoun D, Lambert M, Mirault T, et al. Retrospective analysis of surgery versus endovascular intervention in Takayasu arteritis: a multicenter experience. Circulation 2012; 125: 813-9.
Wrotniak L, Kabłak-Ziembicka A, Przewłocki T, et al. Long-term experience in patients undergoing endovascular revascularization procedures for symptomatic Takayasu arteritis. J Rare Cardiovasc Dis 2013; 1: 8-13.
Horie N, Hayashi K, Morikawa M, et al. Restenosis after endovascular PTA/stenting for supra-aortic branches in Takayasu aortitis: report of three cases and review of the literature. Acta Neurochir (Wien) 2011; 153: 1135-9.
Spacek M, Zimolova P, Veselka J. Takayasu arteritis: use of drug-eluting stent and balloon to treat recurring carotid restenosis. J Invasive Cardiol 2012; 24: E190-2.
Hu J, Huang H, Zhang X, et al. Stent placement for treatment of long segment (≥80 mm) carotid artery stenosis in patients with Takayasu disease. J Vasc Interv Radiol 2012; 23: 1473-7.
Perera AH, Youngstein T, Gibbs RG, et al. Optimizing the outcome of vascular intervention for Takayasu arteritis. Br J Surg 2014; 101: 43-50.
Brott TG, Halperin JL, Abbara S, et al. ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease. J Am Coll Cardiol 2011; 57: 1002-44.
Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients. Arteritis Rheum 2007; 56: 1000-9.
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