J Yeungnam Med Sci.  2023 Oct;40(4):448-453. 10.12701/jyms.2023.00122.

Endovascular treatment of Takayasu arteritis in a middle-aged woman with syncope and limb claudication: a case report

• Choi HY
• Lee S
• Park J
• Song YJ
• Kim DK
• Kim KH
• Seol SH
• Kim DI
• Kim S

• KMID: 2547372
• DOI: http://doi.org/10.12701/jyms.2023.00122

Abstract

Takayasu arteritis (TA) is a disease that causes inflammation and stenosis of medium to large blood vessels. We report a case of a 50-year-old female patient with newly developed hypertension, syncope, and claudication of the extremities. Total occlusion of the left subclavian artery at the origin was found and significant stenosis of the right common iliac artery was revealed by hemodynamic analysis. She was successfully treated with percutaneous angioplasty for multiple peripheral arterial diseases and was finally diagnosed with TA. In consultation with a rheumatologist, medical treatment for TA was initiated, the patient’s hypertension disappeared, and her claudication symptoms improved.

Keyword

Percutaneous transluminal angioplasty; Subclavian steal syndrome; Takayasu arteritis

Figure

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  Fig. 1. Angio-upper extremity computed tomography shows total occlusion of the left subclavian artery (arrows). (A) Axial view. (B) The maximum intensity projection image.

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  Fig. 2. Angio-lower extremity computed tomography shows mild stenosis of the right common iliac artery (arrows). (A) Axial view. (B) The maximum intensity projection image.

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  Fig. 3. Hemodynamic evaluation using catheter-guided translesional pressure gradient shows significant stenosis at the right common iliac artery. (A) Angiography, (B) prestenotic pressure, and (C) poststenotic pressure.

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  Fig. 4. (A) Pre-PTA (digital subtraction angiography image of the left subclavian artery). (B) Antegrade guidewire in the right direction through intraluminal space using bidirectional guidewire. (C) Antegrade guidewire entered the retrograde guide sheath. (D) Post-PTA (digital subtraction angiography image of the left subclavian artery). PTA, percutaneous transluminal angioplasty.

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  Fig. 5. Digital subtraction angiography images of the right common iliac artery. (A) Pre-PTA, (B) Post-PTA. PTA, percutaneous transluminal angioplasty.

Reference

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