Surgical Treatment of Takayasu Arteritis.
- Author:
Moon Sang AHN
1
;
Min Young KIM
;
Seung HUH
;
Seung Kee MIN
;
Jongwon HA
;
Jung Kee CHUNG
;
Sang Joon KIM
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. sjkimgs@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Takayasu arteritis;
Renovascular hypertension;
Surgery
- MeSH:
Acute Kidney Injury;
Aorta;
Aortic Coarctation;
Autografts;
Cerebrovascular Disorders;
Extremities;
Female;
Humans;
Hypertension;
Hypertension, Renovascular;
Ischemia;
Male;
Mortality;
Seoul;
Takayasu Arteritis*;
Transplants;
Upper Extremity
- From:Journal of the Korean Society for Vascular Surgery
2001;17(1):24-31
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Takayasu arteritis is an inflammatory arteriopathy which predominantly affects young females and involves the aorta and its major branches. There is little information on reconstructive arterial surgery for Takayasu arteritis. We aim to evaluate the effectiveness and safety of the operation performed for symptomatic Takayasu arteritis. METHOD: Eighteen patients (5 men and 13 women) with Takayasu arteritis treated surgically from 1985 to 1999 at Seoul National University Hospital were reviewed. RESULT: Hypertension was the main symptom in our patients. Four paitients initially underwent medical treatment. Eighteen patients have undergone 21 vascular procedures for the occlusive arterial disease. Surgical indications included renovascular hypertension (17), cerebrovascular insufficiency (3), and extremity ischemia (1). Twelve patients with renovascular hypertension treated by unilateral or bilateral aortorenal bypass. Six patients have undergone renal autotransplantation. Aorto-aortic bypass was performed in 4 abdominal aortic coarctation. Two patients with cerebrovascular ischemia were treated by aortocarotid bypass. One patient with upper extremity and cerebrovascular ischemia have undergone femoroaxillary bypass and axillovertebral bypass. There were no postoperative mortality or morbidity except acute renal failure in one patients with full recovery. Revision of the initial reconstruction has been required for recurrent renovascular hypertension in two patients. All patients except two showed beneficial effect after procedures for renovascular hypertension. CONCLUSION: Surgical treatment of symptomatic Takayasu arteritis is highly effective and safe. Symptomatic improvement and excellent long-term graft patency can be expected after arterial reconstrucion. Considering their young age, aggressive surgical intervention is needed in the patient with Takayasu arteritis.
