J Korean Soc Vasc Surg.  2008 May;24(1):34-38.

Surgical Treatment for Cerebrovascular Disease in Takayasu's Arteritis

Affiliations
  • 1Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. twkwon2@amc.seoul.kr

Abstract

PURPOSE: Takayasu's arteritis is a chronic disease characterized by nonspecific inflammation of the aorta and its branches, and cerebral ischemia has been considered to be the most life-threatening complication of this disorder. METHOD: We performed a retrospective review of 13 patients who underwent 16 procedures between 1996 and 2006 secondary to cerebrovascular symptoms in Takayasu's arteritis (median follow-up=52.5 months). RESULT: Study subjects included 10 females and 3 males, with a median age of 36.5 years. Procedures included 7 bypasses (2 aorto-bicarotid artery, 1 axillo-axillary artery, 2 subclavian-common carotid artery, 1 common carotid-internal carotid artery, and 1 axillo-vertebral artery), 4 carotid endarterectomies (CEA), and 5 stents (4 common carotid artery [1 for the treatment of re-stenosis of CEA] and 1 vertebral artery). All patients were relieved of their cerebral ischemic symptoms and remained stroke-free during the follow-up period. Re-stenosis was seen in two cases of stenting. Occlusion or stenosis of arterial reconstruction occurred more frequently in patients who had elevated erythrocyte sedimentation rates (ESR) preoperatively (P<0.05).
CONCLUSION
Surgical treatment was effective in stroke prevention and elimination of cerebrovascular symptoms. The patency of the reconstruction was related to the progression of the disease as indicated by elevated ESR and [18F]fluorodeoxyglucose positron emission tomography, which are useful tools for evaluating disease activity.

Keyword

Takayasu's arteritis; Cerebrovascular disorders

MeSH Terms

Aorta
Arteries
Blood Sedimentation
Brain Ischemia
Carotid Arteries
Carotid Artery, Common
Cerebrovascular Disorders
Chronic Disease
Constriction, Pathologic
Endarterectomy, Carotid
Female
Follow-Up Studies
Humans
Inflammation
Male
Positron-Emission Tomography
Retrospective Studies
Stents
Stroke
Takayasu Arteritis
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