Long-term survival after surgical treatment of patients with Takayasu's arteritis

Miyata, Tomoko; Sato, Osamu; Koyama, Hideo; Shigematsu, Hisayuki; Tada, Yutaka

doi:10.1016/j.accreview.2004.02.077

Cited by 23 publications

(41 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although cardiac failure is the leading cause of death in TA [20], ischemic events such as acute myocardial infarction and massive stroke were the commonest causes of death in our study.…”

mentioning

confidence: 60%

“…However, stenotic or occlusive lesions may require surgical treatment if hemodynamically signiWcant. Unfortunately, restenosis is a major concern in patients who underwent vascular surgical procedures, mainly for those with active disease at the time of the intervention [1,11,[18][19][20]. In this study, we perform a longitudinal analysis of medical therapy in TA patients, comparing its eYcacy based on clinical activity criteria, development of new arterial lesions and modiWcation of angiographic type along follow-up.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Takayasu arteritis: assessment of response to medical therapy based on clinical activity criteria and imaging techniques

et al. 2010

View full text Add to dashboard Cite

In this retrospective longitudinal cohort study we included 52 patients with Takayasu arteritis (TA) who were on regular follow-up at the Vasculitis Unit of Universidade Federal de São Paulo between 2003 and 2009. The mean age at study was 38 years and the mean age at diagnosis was 29 years. Patients were followed for a mean 74.3 months. A relapse-remitting course was observed in 41 patients (78.8%) whereas 9 (17.3%) had a monophasic course and only 2 (3.8%) patients were chronic-active. Disease remission was achieved in 50 patients (96.2%). Angiographic type V was observed in 42.3% of TA patients at diagnosis and in 61.5% during follow-up. The most affected arteries were the abdominal aorta (63.5%) and left subclavian (60.6%). Prednisone was used by 94% of TA patients and immunosuppressive agents were prescribed for 51 (98%) patients. Methotrexate was used by 82.7%, followed by cyclophosphamide (26.9%), azathioprine (25.0%), anti-TNFα agents (5.8%) and leflunomide (5.8%). Although, forty patients (76.9%) used prednisone and methotrexate as initial treatment, 75% of them developed new vascular lesions along follow-up. Eighteen TA patients (34.6%) needed to change immunosuppressive therapy due to failure or toxicity, among them 83.3% presented new lesions. Surgical treatment was performed in 34.6% of patients and restenosis was observed in 13.5% in a median time of 11 months after surgery. In conclusion besides prednisone and methotrexate is largely used in TA, the majority of patients still develop new arterial lesions along time.

show abstract

“…Although cardiac failure is the leading cause of death in TA [20], ischemic events such as acute myocardial infarction and massive stroke were the commonest causes of death in our study.…”

mentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Takayasu arteritis: assessment of response to medical therapy based on clinical activity criteria and imaging techniques

et al. 2010

View full text Add to dashboard Cite

show abstract

“…92 Reportedly, the subjective and objective ophthalmologic fi ndings improve after reconstruction of the carotid artery. Slusher and Richards 93 reconstructed carotid arteries of a patient with Takayasu disease who repeatedly experienced transient amaurosis.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Takayasu disease on the centenary of its discovery

et al. 2009

View full text Add to dashboard Cite

Takayasu disease was first reported in 1908 by Mikito Takayasu as "a case of peculiar changes in the central retinal vessels." Because in these patients the pulse of the radial artery is impalpable, investigations focusing on the ischemic symptoms of the upper body were conducted. In 1948, Shimizu and Sano named this pathological condition "pulseless disease." Since then, the lesions of Takayasu disease have been detected not only in the aortic arch and its main branches but also in various vessels, including the abdominal aorta and renal arteries. The ocular symptoms of Takayasu disease are considered to be due to ischemia in the retina and choroid. The typical wreath-like arteriovenous anastomosis around the disc reported by Takayasu is observed at a relatively late stage of the disease. The characteristic fundus findings of Takayasu disease include tortuosity and dilatation of the central retinal artery and vein, retinal arteriovenous anastomosis, prominent retinal vasculature, microaneurysms in the capillaries, occlusion of retinal arterioles, soft exudate, choked disc, and optic atrophy. Fluorescein angiography reveals retinal microaneurysms, sludging, slower blood flow, dilatation of retinal vessels, leakage of fluorescence dye due to increased vascular permeability, and arteriovenous anastomosis. Arteriovenous anastomosis initially appears in the periphery at the early stage, and in the arteriovenous crossing at the advanced stage. Systemic administration of corticosteroids is required to prevent vascular stenosis during the early stages of Takayasu disease. Reconstruction of the carotid artery may improve subjective symptoms and fundus findings.

show abstract

“…Ergebnisse einer retrospektiven Analyse von 106 gefäßchirurgisch behandelten Patienten mit Takayasu-Arteriitis zeigen, dass operative Therapieverfahren additiv zur immunsuppressiven Therapie die Prognose von Patienten mit Komplikationen und refraktärem Verlauf (z.B. bei großen Aneurysmen) verbessern [127]. Bei früheren Krankheitsstadien überwiegen Komplikationen durch die gefäßchirurgische Intervention hingegen deren Nutzen [127].…”

Section: Therapieunclassified

“…bei großen Aneurysmen) verbessern [127]. Bei früheren Krankheitsstadien überwiegen Komplikationen durch die gefäßchirurgische Intervention hingegen deren Nutzen [127].…”

Section: Therapieunclassified

Rheumatology—Part 3. Research News Concerning Epidemiology, Di-agnosis, and Therapy of Primary Systemic Vasculitides

et al. 2006

View full text Add to dashboard Cite

Antineutrophil cytoplasmic autoantibody-(ANCA-)associated vasculitides, immune complex-mediated vasculitides and granulomatous arteritides of unknown etiology belong to the group of primary systemic vasculitides. Numerous in vitro and in vivo studies have underscored the role of ANCA in the pathogenesis of ANCA-associated vasculitides (Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome) in the meantime. Whereas the pathogenicity of myeloperoxidase (MPO) ANCA has been supported by data from various animal models in the past, the in vivo pathogenicity of proteinase 3 (PR3) ANCA has been demonstrated in an animal model only recently. Other studies showed an altered T-cell response in Wegener's granulomatosis. Hepatitis C virus-(HCV-)associated cryoglobulinemic vasculitis is mediated by immune complexes. Recent data suggest that the HCV core particles concentrated in the cryoprecipitate apparently play a role in the interaction of cryoglobulin and endothelial cells and neutrophil granulocytes. Data from the European Vasculitis Study Group (EUVAS) demonstrate the efficacy of azathioprine in maintaining remission in ANCA-associated vasculitides on the basis of large patient numbers. Biologicals play an increasing role in the treatment of refractory vasculitis.

show abstract

Long-term survival after surgical treatment of patients with Takayasu's arteritis

Cited by 23 publications

References 0 publications

Takayasu arteritis: assessment of response to medical therapy based on clinical activity criteria and imaging techniques

Takayasu arteritis: assessment of response to medical therapy based on clinical activity criteria and imaging techniques

Takayasu disease on the centenary of its discovery

Rheumatology—Part 3. Research News Concerning Epidemiology, Di-agnosis, and Therapy of Primary Systemic Vasculitides

Contact Info

Product

Resources

About