Takayasu's arteritis treated by percutaneous transluminal angioplasty with stenting in the descending aorta

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Surgery

Background:

• Takayasu's arteritis is a rare, chronic inflammatory disease affecting large arteries, primarily the aorta and its branches.
• It predominantly affects young women, leading to stenosis, occlusion, or aneurysms.
• Early diagnosis and intervention are crucial to prevent severe complications.

Observation:

• A 17-year-old female presented with a 2-year history of lower extremity claudication and severe arterial hypertension.
• Physical examination revealed significant blood pressure discrepancies between upper and lower extremities.
• Elevated inflammatory markers (ESR, CRP) and 3D CT angiography confirmed stenotic changes in the aorta and its branches, consistent with Type IIb Takayasu's arteritis.

Findings:

• Percutaneous transluminal angioplasty with stenting successfully treated the thoracic and abdominal aorta stenosis.
• Post-intervention, upper extremity blood pressure normalized, and lower extremity claudication resolved.
• The patient remained symptom-free with no cardiac events during a 2-year follow-up.

Implications:

• This case highlights the importance of considering Takayasu's arteritis in young patients with unexplained hypertension and claudication.
• Endovascular intervention, including angioplasty and stenting, can be an effective treatment for aortic stenosis in Takayasu's arteritis.
• Successful management can significantly improve quality of life and prevent long-term cardiovascular complications.