Drug coated balloon angioplasty for renal artery stenosis due to Takayasu arteritis: Report of five cases

Abstract

BACKGROUNDTakayasu arteritis is a rare but intractable chronic disease in young female patients. Percutaneous transluminal angioplasty of the involved renal arteries has been reported; however, few studies have reported the use of drug coated balloon angioplasty in the treatment of Takayasu arteritis. We aimed to demonstrate five young female patients who presented with a history of hypertension due to Takayasu arteritis.CASE SUMMARYFrom April 2017 to October 2018, five female patients were diagnosed with hypertension due to Takayasu arteritis by computed tomography angiography (CTA) and laboratory tests. Four patients had a complaint of headache with or without dizziness, and one patient showed no symptom. There was no significant family or past history of hypertension or kidney disease, and the physical examinations were almost normal on admission. We performed a treatment by drug coated balloon angioplasty. Blood pressure decreased dramatically in all patients after balloon angioplasty, and the patency of treated renal artery was demonstrated with CTA over 5 months after the angioplasty procedure.CONCLUSIONDrug coated balloon angioplasty is safe and effective for renal artery stenosis due to Takayasu arteritis. A prospective study with a larger sample size is necessary to further demonstrate the effectiveness of the treatment.

Research progress of drug eluting balloon in arterial circulatory system

“…Notably, Yamamoto et al reported a case of a patient with aortitis-induced renal artery stenosis who underwent multiple renal angioplasty treatments before achieving blood flow velocities similar to those after two years of drug balloon therapy ( 94 ). Similar outcomes were observed in five patients with aortitis who received pharmacological balloon treatment, as reported in another study ( 66 ). Nevertheless, further research is required to fully understand the efficacy of drug balloon therapy for aortitis-related renal artery stenosis.…”

Drug-Coated Balloon Angioplasty for Thoracic Great Vessel Stenosis Due to Takayasu Arteritis With 1-Year Follow-up

“…7 Drug-coated balloon angioplasty has recently been used to treat stenotic lesions caused by Takayasu arteritis. 4,8 To our knowledge, the use of DCBs to treat arterial stenosis involving all the major branches of the thoracic aorta due to Takayasu arteritis has not been reported.…”

“…3 Balloon angioplasty has been reported to have better long-term patency compared with stent placement for treatment of renal artery stenosis caused by Takayasu arteritis. 3 Drug-coated balloon (DCB) angioplasty has also been used to treat renal artery stenosis caused by Takayasu arteritis, 4 but to the best of our knowledge, the efficacy of DCB for treatment of stenosed thoracic arteries caused by Takayasu arteritis remains anecdotal. We present a case of a 24-yearold female with narrowing or occlusions of the innominate, right common carotid, left common carotid, left vertebral, left internal carotid, and left subclavian arteries who underwent vascular intervention by DCB angioplasty and stent placement.…”

Long-term outcomes of angioplasty for pediatric renovascular hypertension: A single-center experience

“…DCB was used only in one TA patient with restenosis, and no restenosis has occurred in the past 2 years. Bi et al 23 used DCB to effectively treat five TA-related RVH patients (≤ 18 years old); no restenosis occurred during follow-up (range: 5.1–23.8 months). Larger studies are required to provide more definitive evidence of the effectiveness of DCB in pediatric RVH.…”