Long‑term experience in patients undergoing endovascular revascularization procedures for symptomatic Takayasu arteritis (RCD code: I-3A.1)

Leszek Wrotniak, Anna Kabłak‑Ziembicka, Tadeusz Przewłocki, Piotr Pieniążek, Jakub Podolec, Piotr Musiałek, Krzysztof Żmudka, Piotr Podolec

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Abstract


Takayasu arteritis (TA) is often manifested by a prolonged limb claudication, renovascular hypertension or a sudden ischemic stroke (IS) or myocardial infarction (MI) occurring in young adults. The study aimed to assess the long‑term outcome in patients with TA referred to endovascular revascularization procedure (PTA). Methods. The study group comprised 20 patients with TA (19 women, 1 men), at the mean age of 45.3±6.6 (range 30–52) years at the time of the first diagnosis of an arterial stenosis. In 70% of patients significant stenosis or occlusion affected more than one major arterial territory. Significant coronary stenosis was observed in 8(40%) patients. All patients were assessed for the prevalence of cardiovascular risk factors, inflammatory activity (hs‑CRP, white blood count: – WBC) and the incidences of restenosis (RS), cardiovascular death (CVD), MI, IS/TIA or symptomatic lesion progression at follow‑up (SLP). Results. A total of 28 PTAs were performed as a result of the initial evaluation, including 11 subclavian or innominate, 6 carotid, 8 renal,  1 vertebral, 1 coronary and 1 PTA of the abdominal aorta. During the follow‑up period of 98 ±28 months (range 12–165 months), CV events occurred in 3(15%) patients, including 1(5%) CVD, 1(5%) IS, and 1(5%) IM. SLP was observed in 11(55%) patients in 17 previously non obstructed arterial locations. 14 of these lesions required PTA. Significant RS in at least one revascularized artery concerned 11(55%) patients and was observed in case of 13 previously performed PTA’s; 11 of those lesions required re‑PTA. Recurrent RS was noted in 4 patients. Conclusions. In patients with TA, RS and SLP rates are high, thus the follow‑up of these patients is crucial. PTA is a valuable alternative to surgery for patients with TA. JRCD 2013; 1 (5): 8–13


Keywords


Takayasu arteritis; endovascular revascularization; cardiovascular events; restenosis; lesion progression; long‑term

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DOI: http://dx.doi.org/10.20418%2Fjrcd.vol1no5.130

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Journal of Rare Cardiovascular Diseases (JRCD)
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