Surgical technique for management of Takayasu's arteritis

Anastomotic aneurysm may occur after surgical treatment of Takayasu's arteritis. We describe a surgical technique designed to prevent this problem. The technique includes a bypass from a donor artery to a nondiseased distal artery, reinforcement of the suture line to prevent stretching or expansion at the anastomoses, and minimization of inflow perfusion to the brain. The technique was used in two patients, whose grafts were patent 1 and 2 years, respectively, after surgery. Careful differential diagnosis is essential to the success of this method, which may also be used to treat aortic aneurysm resulting from Behcet's disease but which is not appropriate for mid-aortic syndrome or Buerger's disease.