Carotid and coronary artery occlusion in a patient with Takayasu arteritis

Area of Science:

• Cardiovascular Medicine
• Neurology
• Rheumatology

Background:

• Takayasu arteritis (TA) is a rare, chronic inflammatory condition affecting large arteries, primarily the aorta and its branches.
• Vessel stenosis and occlusion in TA can lead to diverse clinical presentations, including neurological deficits like stroke.
• Early diagnosis and management are crucial to prevent severe vascular complications.

Observation:

• This report details a case of a young male diagnosed with Takayasu arteritis.
• The patient presented with complete thrombotic occlusion of the right common carotid artery, necessitating surgical intervention.
• Postoperative imaging revealed an additional critical finding: total proximal occlusion of the left anterior descending coronary artery.

Findings:

• Takayasu arteritis can manifest with severe cerebrovascular complications, such as carotid artery occlusion.
• The disease progression can involve multiple major arterial territories, including coronary arteries, even after initial surgical management for other affected vessels.
• Coronary artery involvement, specifically left anterior descending artery occlusion, was identified post-operatively in this TA patient.

Implications:

• This case highlights the potential for Takayasu arteritis to cause simultaneous or sequential severe occlusive disease in both cerebrovascular and coronary circulations.
• Aggressive inflammatory processes in TA underscore the need for comprehensive vascular surveillance beyond the initially diagnosed site.
• Timely and thorough diagnostic workup, including advanced imaging, is essential for identifying the full extent of arterial involvement in Takayasu arteritis patients.