A Case of Takayasu's Arteritis That Developed Impending Ruptured Subclavian Artery Aneurysm Associated with Sepsis during Steroid Therapy
10.4326/jjcvs.33.433
- VernacularTitle:ステロイド投与中に菌血症，鎖骨下動脈りゅう切迫破裂をきたした高安動脈炎の１例
- Author:
Takashi Kunihara
;
Kazuhiro Eya
;
Tsukasa Miyatake
;
Norihiko Shiiya
;
Keishu Yasuda
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2004;33(6):433-436
- CountryJapan
- Language:Japanese
-
Abstract:
A 20-year-old woman had intermittent fever frequently since dental therapy one year previously. Two months previously Takayasu's arteritis had been diagnosed and she had been given 30mg/day prednisolone. She then developed subarachnoid hemorrhage, left arm pain/cataplexy, purpura, sight disturbance, and sepsis caused by Serratia. Finally she felt chest pain and a left Subclavian artery pseudoaneurysm was detected out. Therefore she was transferred to our service for emergency surgery. Preoperative angiography demonstrated post-stenosis aneurysm in the right common carotid artery, left common carotid artery aneurysm, and saccular pseudoaneurysm in the left subclavian artery that suggested impending rupture. The operation was performed through a left upper partial sternotomy extended to the left supraclavicular space. The left subclavian artery was ligated proximal to the aneurysm and distal portion was also ligated through a subclavicular approach. The postoperative course was uneventful. No ischemic sign has been seen in her left arm one year after operation and left/right brachial artery pressure index has improved to 0.80. The patient currently takes steroids and remains healthy without signs of expansion of bilateral carotid artery aneurysms.
