Endovascular Revascularization for Carotid Artery Occlusion in Patients with Takayasu Arteritis

Chen, B.; Yu, Heng; Zhang, J.; Li, X.X.; Wu, Xiaoying; Yang, Shin‐Seok; Qi, Yu; Yan, Chenglan; Wang, Z.G.

doi:10.1016/j.ejvs.2015.01.018

Cited by 25 publications

(23 citation statements)

References 23 publications

(19 reference statements)

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“…Open surgery is generally not recommended until the active stage of TA is controlled. 14,15 However, two studies reported that the rate of restenosis does not increase in patients with active stage TA if immunosuppressive treatment is administered. 16,17 In the present study, the 12 Ascending aorta e bilateral carotid e ABVe bypass.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Multi-Supra-Aortic Artery Bypass Successfully Implemented in 17 Patients with Type I Takayasu Arteritis

Chen

Diao

et al. 2018

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS Type I Takayasu arteritis (TA) is a progressive inflammatory disease involving the aortic arch and its main branches. If untreated, patients may develop hemiplegia or die at a young age. However, few cases have focused on simultaneous multi-supra-aortic artery (SMSAA) bypass in patients with type I TA. This study shares a large experience with this technique, and describes the results of simultaneous open surgical treatment of multiple supra-aortic trunk vessels affected by TA.Objective: Type I Takayasu arteritis is common in Chinese patients and usually leads to cerebral ischaemia. There are limited data regarding simultaneous multi-supra-aortic artery (SMSAA) bypass in patients with type I Takayasu arteritis. The present study shares experience of using this method. Methods: Seventeen patients with Takayasu arteritis who received SMSAA bypass from June 2012 to March 2016 were included in this analysis. Demographic features and basic information were recorded. Follow up results, including major complications, patency rates, and survival rates, were also obtained. The EQ-5D questionnaire was also administered to evaluate the quality of life of patients. Results: Among these 17 patients, there were 77 supra-aortic arteries affected by TA and 37 arteries were reconstructed, 10 with great saphenous vein and 27 with artificial blood vessels. All the operations were technical successes and the mean operation time was 396.6 AE 93.4 min. The patients were followed for a mean of 25.2 AE 12.3 months. Two graft restenoses were found, and both were successfully recanalised by balloon dilatation. One patient suffered a minor stroke but was free from obvious sequelae. No major complications, recurrent symptoms, or deaths occurred during the follow up period. The EQ-5D questionnaire scores were significantly improved after the operation compared with the pre-operative scores (87.14 AE 8.25 vs. 58.93 AE 14.4, p < .01), and all the patients enjoyed a satisfactory quality of life. Conclusion: SMSAA bypass in type I Takayasu arteritis can be effectively and safely performed with rigorous perioperative management. Maintaining the patency of the bypass graft relieves the symptoms of cerebral ischaemia and helps sustain patients' quality of life. Ó

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Section: Discussionmentioning

confidence: 99%

Simultaneous Multi-Supra-Aortic Artery Bypass Successfully Implemented in 17 Patients with Type I Takayasu Arteritis

Chen

Diao

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…The treatment of patients with multiple aortic arch branch involvement, including their occlusion, has been widely described [7,8,[15][16][17][18][19][20][21][22][23][24][25]. In most cases of patients with the active inflammatory phase of TA, the immunosuppressive treatment alone may be effective in reducing the cerebral ischaemic Photo 1.…”

Section: Is Minimally Invasive Treatment Still Possible In Multiple Ementioning

confidence: 99%

“…Sometimes surgical treatment is needed [15,17,18]. Both methods -endovascular and surgical -are featured with good long-and short-term results, provided that the patients undergo proper treatment [7,8,17,18].…”

Section: Is Minimally Invasive Treatment Still Possible In Multiple Ementioning

confidence: 99%

“…The surgical treatment is considered to be safe and effective regardless of disease activity [17]. Some authors stress that conventional bypasses are featured with better long-term patency than endovascular options; however, adequate immunosuppression and qualification of patients to surgical treatment may give satisfactory results in both kinds of methods [7,8]. We prefer the endovascular options first.…”

Section: Is Minimally Invasive Treatment Still Possible In Multiple Ementioning

confidence: 99%

“…They reach almost up to 70% patency in a five-year follow-up in bypass surgery. In endovascular methods, long-term results vary from 0 to 70% of restenosis rate, with a follow-up period of 0.5 to 5 years -improving with the advances of endoluminal techniques and equipment [6][7][8][9]. Wrotniak et al showed that endovascular treatment is safe and effective in symptomatic patients and is featured with a relatively low complication rate of 7.1% in a 30-day period [9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multiple occlusions in extracranial arteries in patients with aortic arch syndrome: is minimally invasive treatment still possible? Technical aspects of the treatment based on our own experience and a review of the literature.

Kaszczewski¹,

Ostrowski²,

Maciąg³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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Takayasu arteritis is a large vessel vasculitis of granulomatous nature and unknown aetiology affecting predominantly the aorta and its major branches, which may lead to ischaemic symptoms of many organs including the central nervous system. To decrease the risk of neurological complications and improve the quality of life, an arterial revascularisation may be necessary. The treatment options include pharmacotherapy as well as both open surgical and endovascular procedures, which has to be carefully chosen to obtain clinical success. There is an ongoing debate on the advantages, possibilities, and indications for implementing endovascular and open surgical methods, especially in high-risk patients. In this article we present our own experience in the treatment of an unusually complex and high-risk patient with multiple occlusion of supra-aortic branches, focusing on the technical aspects of the procedures and the decision-making process, as well as to confront with contemporary medical knowledge.

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2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis

Maz

Chung

Abril

et al. 2021

Arthritis Care & Research

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Objective. To provide evidence-based recommendations and expert guidance for the management of giant cell arteritis (GCA) and Takayasu arteritis (TAK) as exemplars of large vessel vasculitis.Methods. Clinical questions regarding diagnostic testing, treatment, and management were developed in the population, intervention, comparator, and outcome (PICO) format for GCA and TAK (27 for GCA, 27 for TAK). Systematic literature reviews were conducted for each PICO question. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of the evidence. Recommendations were developed by the Voting Panel, comprising adult and pediatric rheumatologists and patients. Each recommendation required ≥70% consensus among the Voting Panel.Results. We present 22 recommendations and 2 ungraded position statements for GCA, and 20 recommendations and 1 ungraded position statement for TAK. These recommendations and statements address clinical questions relating to the use of diagnostic testing, including imaging, treatments, and surgical interventions in GCA and TAK. Recommendations for GCA include support for the use of glucocorticoid-sparing immunosuppressive agents and the use of imaging to identify large vessel involvement. Recommendations for TAK include the use of nonglucocorticoid immunosuppressive agents with glucocorticoids as initial therapy. There were only 2 strong recommendations; the remaining recommendations were conditional due to the low quality of evidence available for most PICO questions.Conclusion. These recommendations provide guidance regarding the evaluation and management of patients with GCA and TAK, including diagnostic strategies, use of pharmacologic agents, and surgical interventions.Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient's individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice. ACR recommendations are not intended to dictate payment or insurance decisions, and drug formularies or other third-party analyses that cite ACR guidelines should state this. These recommendations cannot adequately convey all uncertainties and nuances of patient care.

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Endovascular Revascularization for Carotid Artery Occlusion in Patients with Takayasu Arteritis

Cited by 25 publications

References 23 publications

Simultaneous Multi-Supra-Aortic Artery Bypass Successfully Implemented in 17 Patients with Type I Takayasu Arteritis

Simultaneous Multi-Supra-Aortic Artery Bypass Successfully Implemented in 17 Patients with Type I Takayasu Arteritis

Multiple occlusions in extracranial arteries in patients with aortic arch syndrome: is minimally invasive treatment still possible? Technical aspects of the treatment based on our own experience and a review of the literature.

2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis

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