Natural history of aortoarteritis (Takayasu's disease).

Abstract

The natural history of aortoarteritis was studied in 88 patients (54 women and 34 men). The average age was 24.0±8.8 years at onset of symptoms and 28.3±9.9 years at diagnosis. The inflammatory disease involving the aorta, the arteries arising from the aorta, and, frequently, the pulmonary arteries. The inflammation leads to either stenosis and occlusion of the involved artery or aneurysm formation or both.1-5 The arterial lesions can lead to secondary hypertension, retinopathy, cardiac involvement, cerebrovascular events, and premature death. The course and prognosis of patients with aortoarteritis show wide variation, and few authors have published systematic studies documenting the natural history of this disease.6-9 While the etiology of aortoarteritis remains unknown, various modes of treatment including steroids, vascular surgery, and balloon angioplasty have been used for management of these patients.7"10-13 To make a decision about elective intervention, the physician must have data on the natural history and be able to make an objective assessment of the prognosis in the individual patient. Our study documents the clinical course, complications, and survival of 88 patients with aortoarteritis who had systematic follow-ups at our center.

Single Stage Multiple Stenting in Takayasu's Arteritis

“…10,14,15,18) Severe hypertension, severe functional disability, and evidence of cardiac involvement are good predictors of either death or a major To manage active arteritis, an initial dose of corticosteroid administered at 1 mg/kg/day for one month, and then tapered down to less than 10 mg/day, is the initial mainstay of medical therapy for patients with Takayasu's arteritis. 4,9) However, studies report that only 20% of patients with Takayasu's arteritis maintain remission for 6 months on less than 10 mg prednisone.…”

“…5) Takayasu's arteritis often induces cerebrovascular accidents as well as ischemic heart disease, cardiac failure, aneurysm, renal failure, retinopathy, and hypertension. 10,15,18) The overall survival percentage in patients with Takayasu's arteritis at 10 years after diagnosis is 80.3%, and the event-free survival percentage at 10 years is 61.6%. 15) However, the treatment for Takayasu's arteritis has not been well established to date.…”

“…10,15,18) The overall survival percentage in patients with Takayasu's arteritis at 10 years after diagnosis is 80.3%, and the event-free survival percentage at 10 years is 61.6%. 15) However, the treatment for Takayasu's arteritis has not been well established to date. Endovascular interventions, such as percutaneous transluminal balloon angioplasty (PTBA), have shown success in relieving stenotic lesions of major arteries in recent studies.…”

Avaliação não invasiva das propriedades estruturais de grandes artérias em pacientes com arterite de Takayasu

“…The finding of elevated PWV in our patients may represent an important issue in the management those affected by this vasculitis since TA is known to be associated with elevated cardiovascular morbidity and mortality [1,16]. The only available study of PWV in TA had a discrepancy in age of controls and a significant difference between groups regarding systolic BP measurements hampering the interpretation of their results [6].…”

“…Takayasu arteritis (TA) predominantly affects large and middle-sized arteries and is related to a higher cardiovascular risk [1,2]. Increased arterial stiffness is associated with atherosclerosis and it is a known independent risk factor for cardiovascular events [3,4].…”