Endovascular stent implantation for severe pulmonary artery stenosis in aortoarteritis (Takayasu's arteritis)

Abstract

Symptomatic pulmonary artery stenosis is a relatively uncommon manifestation of aortoarteritis. We describe a patient of aortoarteritis with severe proximal right pulmonary artery stenosis who presented with dyspnea on exertion and central cyanosis. The pulmonary artery stenosis was successfully relieved by percutaneous transluminal balloon angioplasty and implantation of a balloon-expandable stent. This resulted in immediate improvement in oxygen saturation, disappearance of cyanosis, relief of dyspnea, and marked improvement in right lung perfusion as demonstrated by pre- and postangioplasty technetium lung ventilation-perfusion scans. The changes in the pulmonary arterial wall morphology were detected precisely by intravascular ultrasound imaging.

Intraoperative pulmonary artery stenting in aortoarteritis: a hybrid procedure

“…Management options for pulmonary artery stenosis in aortoarteritis include either percutaneous balloon dilatation with stenting or surgical reconstruction [9,10]. In our patient, a percutaneous approach to stent the RPA was unsuccessful due to technical and anatomical factors.…”

Isolated peripheral pulmonary stenosis in Takayasu arteritis

“…Although involvement of pulmonary arteries is not uncommon in TA, it often accompanies aortic involvement. Isolated stenosis of pulmonary artery branches as an initial manifestation is rarely encountered with only few published reports . It is commonly diagnosed after remarkable progression due to low clinical suspicion.…”

“…Corticosteroid treatment led to improvement in symptoms and pulmonary pressure . Tyagi et al report successful management of a patient with severe RPA stenosis by percutaneous transluminal balloon angioplasty and stenting. Qin et al reported their experience in the management of four patients with pulmonary artery stenosis due to TA using percutaneous transluminal balloon angioplasty and stenting.…”

Pulmonary Vasculitis

“…Cases have been reported of surgical reconstruction of the 2 stenotic branches of the pulmonary artery 9 and of percutaneous transluminal angioplasty with and without stent implantation. 8,10 Medium-vessel Vasculitis…”