Safety and Efficacy of Endovascular Revascularization of Single Patent Arch Artery in Patients with Takayasu Arteritis: Short Term Results

Background: Takayasu arteritis is a form of large vessel vasculitis commonly affecting the aorta and its major branches. Steno-occlusive lesions of all arch vessels can cause severe neurologic symptoms. There is paucity of literature regarding the role of endovascular revascularization in such cases. The present report describes immediate and short term follow-up results with plain balloon angioplasty of severely stenosed single patent arch arteries. Method(s): Angioplasty was performed in 5 consecutive patients with Takayasu arteritis (age, 22 – 50 years; mean, 31.0 ± 12.0416 years) with cerebrovascular symptoms caused by severe stenotic lesions of arch (ie, carotid, vertebral, brachiocephalic and 1st part of subclavian proximal to vertebral take-off) arteries. Result(s): Angioplasty was attempted in 8 stenotic lesions: vertebral (n=3), carotid (n=1), brachiocephalic (n=2) and 1st part of subclavian artery (n=2). Five lesions were discrete and three were diffuse. Balloon angioplasty was performed successfully in all patients. Improvement of luminal diameter from 1.625 mm ± 0.5825 mm to 4.75 mm ± 0.8452 mm (P < .0001), and the reduction in diameter of stenosis from 73.125% ± 14.1263% to 16.25% ± 8.3452% (P < .0001) was observed. No immediate procedure-related complication or significant neurologic deficits occurred. The presenting symptoms improved in all patients. On short term follow-up of upto 4 months, none of the patients had recurrence of neurologic symptoms. Conclusion(s): Plain balloon angioplasty of a sole patent arch artery in Takayasu arteritis is safe and effective, and provides excellent symptomatic relief in such patients.

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Artikel online veröffentlicht:
11. Mai 2021